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Medicare Advantage Plans in Costilla County, Colorado

Below are Medicare Advantage plans available to residents of Costilla county, Colorado. 4 carriers offer 21 plans throughout the county of Costilla. Residents may choose plans from carriers such as Rocky Mountain Health Plans, Colorado Access Advantage and Humana Insurance Company. This data has been made available by the Centers for Medicare & Medicaid Services (CMS) and is for informational purposes only. Some data may be inaccurate or incomplete. Please note that plans can vary by city, county, and state and all plans listed may not be available in all areas. To speak to an advisor and find the Medicare Advantage plan in Costilla county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Costilla

Carrier Plan Title Plan Type
Rocky Mountain Health Plans Rocky Mountain Standard Plan (Cost) (H0602-001) Cost Plan

    Premium and Other Important Information

    • Package: 1 - Dental Services:
    • Package: 2 - Vision Services:
    • $18 monthly premium in addition to your $73.40 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
    • $12 monthly premium in addition to your $73.40 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
    • $1 500 plan coverage limit every year for these benefits.
    • $73.40 monthly plan premium in addition to your monthly Medicare Part B premium.
    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

    Doctor Office Visits

    • $15 copay for each primary care doctor visit for Medicare-covered benefits.
    • $45 copay for each in-area network urgent care Medicare-covered visit
    • $45 copay for each specialist visit for Medicare-covered benefits.
    Rocky Mountain Health Plans Rocky Mountain Plus Plan (Cost) (H0602-003) Cost Plan

      Premium and Other Important Information

      • Package: 1 - Dental Services:
      • Package: 2 - Vision Services:
      • $18 monthly premium in addition to your $156.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
      • $12 monthly premium in addition to your $156.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
      • $1 500 plan coverage limit every year for these benefits.
      • $156.80 monthly plan premium in addition to your monthly Medicare Part B premium.
      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

      Doctor Office Visits

      • $15 copay for each primary care doctor visit for Medicare-covered benefits.
      • $35 copay for each in-area network urgent care Medicare-covered visit
      • $35 copay for each specialist visit for Medicare-covered benefits.
      Rocky Mountain Health Plans Rocky Mountain Standard Plan + Rx (Cost) (H0602-017) Cost Plan

        Premium and Other Important Information

        • Package: 1 - Dental Services:
        • Package: 2 - Vision Services:
        • $18 monthly premium in addition to your $120.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
        • $12 monthly premium in addition to your $120.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
        • $1 500 plan coverage limit every year for these benefits.
        • $120.8 monthly plan premium in addition to your monthly Medicare Part B premium.
        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

        Doctor Office Visits

        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
        • $45 copay for each in-area network urgent care Medicare-covered visit
        • $45 copay for each specialist visit for Medicare-covered benefits.
        Rocky Mountain Health Plans Rocky Mountain Plus Plan + Rx (Cost) (H0602-019) Cost Plan

          Premium and Other Important Information

          • Package: 1 - Dental Services:
          • Package: 2 - Vision Services:
          • $18 monthly premium in addition to your $246.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
          • $12 monthly premium in addition to your $246.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
          • $1 500 plan coverage limit every year for these benefits.
          • $246.2 monthly plan premium in addition to your monthly Medicare Part B premium.
          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

          Doctor Office Visits

          • $15 copay for each primary care doctor visit for Medicare-covered benefits.
          • $35 copay for each in-area network urgent care Medicare-covered visit
          • $35 copay for each specialist visit for Medicare-covered benefits.
          Rocky Mountain Health Plans AB Basic Plan (Cost) (H0602-026) Cost Plan

            Premium and Other Important Information

            • In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply.
            • $5.00 monthly plan premium in addition to your monthly Medicare Part B premium.
            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

            Doctor Office Visits

            • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
            • 20% of the cost for each in-area network urgent care Medicare-covered visit
            • 20% of the cost for each specialist visit for Medicare-covered benefits.
            Rocky Mountain Health Plans Rocky Mountain Thrifty Plan (Cost) (H0602-027) Cost Plan

              Premium and Other Important Information

              • $500 annual deductible. Contact the plan for services that apply.
              • Package: 1 - Dental Services:
              • Package: 2 - Vision Services:
              • $18 monthly premium in addition to your $34 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
              • $12 monthly premium in addition to your $34 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
              • $1 500 plan coverage limit every year for these benefits.
              • $34.00 monthly plan premium in addition to your monthly Medicare Part B premium.
              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

              Doctor Office Visits

              • $20 copay for each primary care doctor visit for Medicare-covered benefits.
              • $50 copay for each in-area network urgent care Medicare-covered visit
              • $50 copay for each specialist visit for Medicare-covered benefits.
              Rocky Mountain Health Plans Rocky Mountain Thrifty Plan + Rx (Cost) (H0602-039) Cost Plan

                Premium and Other Important Information

                • $500 annual deductible. Contact the plan for services that apply.
                • Package: 1 - Dental Services:
                • Package: 2 - Vision Services:
                • $18 monthly premium in addition to your $74.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                • $12 monthly premium in addition to your $74.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                • $1 500 plan coverage limit every year for these benefits.
                • $74.2 monthly plan premium in addition to your monthly Medicare Part B premium.
                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                Doctor Office Visits

                • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                • $50 copay for each in-area network urgent care Medicare-covered visit
                • $50 copay for each specialist visit for Medicare-covered benefits.
                Rocky Mountain Health Plans B Basic Plan (Cost) (H0602-040) Cost Plan

                  Premium and Other Important Information

                  • In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply.
                  • $5.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                  Doctor Office Visits

                  • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
                  • 20% of the cost for each in-area network urgent care Medicare-covered visit
                  • 20% of the cost for each specialist visit for Medicare-covered benefits.
                  Rocky Mountain Health Plans B Standard Plan (Cost) (H0602-041) Cost Plan

                    Premium and Other Important Information

                    • $73.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                    Doctor Office Visits

                    • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                    • $45 copay for each in-area network urgent care Medicare-covered visit
                    • $45 copay for each specialist visit for Medicare-covered benefits.
                    Rocky Mountain Health Plans Rocky Mountain Green Plan (Cost) (H0602-042) Cost Plan

                      Premium and Other Important Information

                      • $500 annual deductible. Contact the plan for services that apply.
                      • Package: 1 - Dental Services:
                      • Package: 2 - Vision Services:
                      • $18 monthly premium in addition to your $8 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                      • $12 monthly premium in addition to your $8 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
                      • $1 500 plan coverage limit every year for these benefits.
                      • $6 700 out-of-pocket limit for Medicare-covered services.
                      • $8.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                      Doctor Office Visits

                      • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                      • $40 copay for each in-area network urgent care Medicare-covered visit
                      • $40 copay for each specialist visit for Medicare-covered benefits.
                      Rocky Mountain Health Plans Rocky Mountain Green Plan + Rx (Cost) (H0602-043) Cost Plan

                        Premium and Other Important Information

                        • $500 annual deductible. Contact the plan for services that apply.
                        • Package: 1 - Dental Services:
                        • Package: 2 - Vision Services:
                        • $18 monthly premium in addition to your $48.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                        • $12 monthly premium in addition to your $48.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
                        • $1 500 plan coverage limit every year for these benefits.
                        • $6 700 out-of-pocket limit for Medicare-covered services.
                        • $48.1 monthly plan premium in addition to your monthly Medicare Part B premium.
                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                        Doctor Office Visits

                        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                        • $40 copay for each in-area network urgent care Medicare-covered visit
                        • $40 copay for each specialist visit for Medicare-covered benefits.
                        Colorado Access Advantage Colorado Access Advantage - Plan E (HMO) (H0621-006) HMO

                          Premium and Other Important Information

                          • $6 700 out-of-pocket limit for Medicare-covered services.
                          • $32.4 monthly plan premium in addition to your monthly Medicare Part B premium.
                          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                          Doctor Office Visits

                          • $0 to $15 copay for each primary care doctor visit for Medicare-covered benefits.
                          • $40 copay for each in-area network urgent care Medicare-covered visit
                          • $0 to $40 copay for each specialist visit for Medicare-covered benefits.
                          Colorado Access Advantage Colorado Access Advantage Plan D (HMO SNP) (H0621-010) HMO

                            Premium and Other Important Information

                            • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                            • In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply.
                            • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                            • $6 700 out-of-pocket limit for Medicare-covered services.*
                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                            Doctor Office Visits

                            • 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.*
                            • 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit*
                            • 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
                            Humana Insurance Company HumanaChoice H0623-001 (PPO) (H0623-001) Local Preferred Provider Organization

                              Premium and Other Important Information

                              • Package: 1 - MyOption Enhanced Dental PPO:
                              • $26 monthly premium in addition to your $61 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                              • $4 500 out-of-pocket limit for Medicare-covered services.
                              • $6 000 out-of-pocket limit for Medicare-covered services.
                              • $61 monthly plan premium in addition to your monthly Medicare Part B premium.
                              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co
                              • Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept

                              Doctor Office Visits

                              • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                              • $35 copay for each in-area network urgent care Medicare-covered visit
                              • $35 copay for each specialist visit for Medicare-covered benefits.
                              • 30% of the cost for each primary care doctor visit
                              • 30% of the cost for each specialist visit
                              Humana Insurance Company HumanaChoice H0623-009 (PPO) (H0623-009) Local Preferred Provider Organization

                                Premium and Other Important Information

                                • Package: 1 - MyOption Vision:
                                • $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                • $290 plan coverage limit every year for these benefits.
                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                • $500 annual deductible. Contact the plan for services that apply.
                                • $5 100 out-of-pocket limit for Medicare-covered services.
                                • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i
                                • Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept

                                Doctor Office Visits

                                • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                • $35 copay for each in-area network urgent care Medicare-covered visit
                                • $35 copay for each specialist visit for Medicare-covered benefits.
                                • 30% of the cost for each primary care doctor visit
                                • 30% of the cost for each specialist visit
                                Humana Insurance Company HumanaChoice H0623-011 (PPO) (H0623-011) Local Preferred Provider Organization

                                  Premium and Other Important Information

                                  • Package: 1 - MyOption Vision:
                                  • $15 monthly premium in addition to your $35 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                  • $290 plan coverage limit every year for these benefits.
                                  • $5 000 out-of-pocket limit for Medicare-covered services.
                                  • $500 annual deductible. Contact the plan for services that apply.
                                  • $6 700 out-of-pocket limit for Medicare-covered services.
                                  • $35 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co
                                  • Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept

                                  Doctor Office Visits

                                  • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                                  • $40 copay for each in-area network urgent care Medicare-covered visit
                                  • $40 copay for each specialist visit for Medicare-covered benefits.
                                  • 30% of the cost for each primary care doctor visit
                                  • 30% of the cost for each specialist visit
                                  Colorado Choice Health Plans Colorado Choice Silver SV Plan (Cost) (H0657-005) Cost Plan

                                    Premium and Other Important Information

                                    • $3 400 out-of-pocket limit for select Medicare-covered services. Contact plan for details regarding Medicare-covered services under this limit.
                                    • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                                    Doctor Office Visits

                                    • $25 copay for each primary care doctor visit for Medicare-covered benefits.
                                    • $40 copay for each in-area network urgent care Medicare-covered visit
                                    • $40 copay for each specialist visit for Medicare-covered benefits.
                                    Colorado Choice Health Plans Colorado Choice Gold SV Plan (Cost) (H0657-006) Cost Plan

                                      Premium and Other Important Information

                                      • $3 400 out-of-pocket limit for select Medicare-covered services. Contact plan for details regarding Medicare-covered services under this limit.
                                      • $30.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                                      Doctor Office Visits

                                      • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                                      • $35 copay for each in-area network urgent care Medicare-covered visit
                                      • $35 copay for each specialist visit for Medicare-covered benefits.
                                      Colorado Choice Health Plans Colorado Choice Platinum SV Plan (Cost) (H0657-007) Cost Plan

                                        Premium and Other Important Information

                                        • $3 400 out-of-pocket limit for select Medicare-covered services. Contact plan for details regarding Medicare-covered services under this limit.
                                        • $55.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                                        Doctor Office Visits

                                        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                        • $30 copay for each in-area network urgent care Medicare-covered visit
                                        • $30 copay for each specialist visit for Medicare-covered benefits.
                                        Humana Insurance Company Humana Gold Choice H8145-120 (PFFS) (H8145-120) Private Fee for Service

                                          Premium and Other Important Information

                                          • Package: 1 - MyOption Fitness Well Being:
                                          • $30 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Supplemental Education/Wellness Programs
                                          • $162 annual deductible. Contact the plan for services that apply.
                                          • $6 700 out-of-pocket limit for Medicare-covered services.
                                          • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i
                                          • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                          Doctor Office Visits

                                          • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                          • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
                                          • 20% of the cost for each in-area network urgent care Medicare-covered visit
                                          • 20% of the cost for each specialist visit for Medicare-covered benefits.
                                          • 20% of the cost for each primary care doctor visit
                                          • 20% of the cost for each specialist visit
                                          Humana Insurance Company Humana Gold Choice H8145-123 (PFFS) (H8145-123) Private Fee for Service

                                            Premium and Other Important Information

                                            • Package: 1 - MyOption Dental High PPO:
                                            • Package: 2 - MyOption Dental Low PPO:
                                            • Package: 3 - MyOption Vision:
                                            • Package: 4 - MyOption Plus:
                                            • $27 monthly premium in addition to your $68 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                            • $17 monthly premium in addition to your $68 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                            • $15 monthly premium in addition to your $68 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                            • $28 monthly premium in addition to your $68 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                                            • $1 500 plan coverage limit every year for these benefits.
                                            • $1 000 plan coverage limit every year for these benefits.
                                            • $290 plan coverage limit every year for these benefits.
                                            • $5 000 out-of-pocket limit for Medicare-covered services.
                                            • $68 monthly plan premium in addition to your monthly Medicare Part B premium.
                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co
                                            • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                            Doctor Office Visits

                                            • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                            • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                            • $35 copay for each in-area network urgent care Medicare-covered visit
                                            • $35 copay for each specialist visit for Medicare-covered benefits.
                                            • $15 copay for each primary care doctor visit
                                            • $35 copay for each specialist visit

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