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New York MedicareAdvantage Plans

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Medicare Advantage Plans in Onondaga County, New York

Below are Medicare Advantage plans available to residents of Onondaga county, New York. 11 carriers offer 37 plans throughout the county of Onondaga. Residents may choose plans from carriers such as Humana Insurance Company of New York, Universal American Corp. and Aetna Medicare. 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 Onondaga county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Onondaga

Carrier Plan Title Plan Type
Humana Insurance Company of New York Humana Gold Choice H1291-001 (PFFS) (H1291-001) Private Fee for Service

    Premium and Other Important Information

    • Package: 1 - MyOption Vision:
    • Package: 2 - MyOption Enhanced Dental PPO:
    • Package: 3 - MyOption Healthy Back:
    • $15 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
    • $36 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
    • $16 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
    • $290 plan coverage limit every year for these benefits.
    • $500 plan coverage limit every year for these benefits.
    • $5 000 out-of-pocket limit for Medicare-covered services.
    • $41 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.
    • $40 copay for each in-area network urgent care Medicare-covered visit
    • $40 copay for each specialist visit for Medicare-covered benefits.
    • $15 copay for each primary care doctor visit
    • $40 copay for each specialist visit
    Humana Insurance Company of New York Humana Gold Choice H1291-003 (PFFS) (H1291-003) 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:
      • Package: 5 - MyOption Healthy Back:
      • $39 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
      • $22 monthly premium in addition to your $0 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 $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
      • $34 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
      • $16 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
      • $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.
      • $500 plan coverage limit every year for these benefits.
      • $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 of New York Humana Gold Choice H1291-007 (PFFS) (H1291-007) 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:
        • Package: 5 - MyOption Healthy Back:
        • $39 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
        • $22 monthly premium in addition to your $31 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 $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
        • $34 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
        • $16 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
        • $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.
        • $500 plan coverage limit every year for these benefits.
        • $162 annual deductible. Contact the plan for services that apply.
        • $6 700 out-of-pocket limit for Medicare-covered services.
        • $31 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.
        • 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
        Universal American Corp. Today's Options Advantage Plus 150A (PPO) (H2775-082) Local Preferred Provider Organization

          Premium and Other Important Information

          • $3 400 out-of-pocket limit for Medicare-covered services.
          • $63 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

          • $10 copay for each primary care doctor visit for Medicare-covered benefits.
          • $35 copay for each in-area network urgent care Medicare-covered visit
          • $30 copay for each specialist visit for Medicare-covered benefits.
          • $15 copay for each primary care doctor visit
          • $35 copay for each specialist visit
          Universal American Corp. Today's Options Advantage Plus 550B (PPO) (H2775-088) Local Preferred Provider Organization

            Premium and Other Important Information

            • $4 400 out-of-pocket limit for Medicare-covered services.
            • $6 000 out-of-pocket limit for Medicare-covered services.
            • $0 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.
            • $20 copay for each primary care doctor visit
            • $40 copay for each specialist visit
            Universal American Corp. Today's Options Advantage 300 (PPO) (H2775-094) Local Preferred Provider Organization

              Premium and Other Important Information

              • $4 400 out-of-pocket limit for Medicare-covered services.
              • $6 000 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

              • $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.
              • $20 copay for each primary care doctor visit
              • $40 copay for each specialist visit
              Universal American Corp. Today's Options Premier 100 (PFFS) (H2816-001) Private Fee for Service

                Premium and Other Important Information

                • $3 400 out-of-pocket limit for Medicare-covered services.
                • $20.00 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.
                • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                • $35 copay for each in-area network urgent care Medicare-covered visit
                • $30 copay for each specialist visit for Medicare-covered benefits.
                • $15 copay for each primary care doctor visit
                • $35 copay for each specialist visit
                Universal American Corp. Today's Options Premier 300 (PFFS) (H2816-007) Private Fee for Service

                  Premium and Other Important Information

                  • $4 400 out-of-pocket limit for Medicare-covered services.
                  • $6 000 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.
                  • $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.
                  • $20 copay for each primary care doctor visit
                  • $40 copay for each specialist visit
                  Universal American Corp. Today's Options Premier Plus 150A (PFFS) (H2816-013) Private Fee for Service

                    Premium and Other Important Information

                    • $3 400 out-of-pocket limit for Medicare-covered services.
                    • $72 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.
                    • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                    • $35 copay for each in-area network urgent care Medicare-covered visit
                    • $30 copay for each specialist visit for Medicare-covered benefits.
                    • $15 copay for each primary care doctor visit
                    • $35 copay for each specialist visit
                    Universal American Corp. Today's Options Premier Plus 350B (PFFS) (H2816-019) Private Fee for Service

                      Premium and Other Important Information

                      • $4 400 out-of-pocket limit for Medicare-covered services.
                      • $6 000 out-of-pocket limit for Medicare-covered services.
                      • $21 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.
                      • $20 copay for each primary care doctor visit
                      • $40 copay for each specialist visit
                      Aetna Medicare Aetna Medicare Value Plan (HMO) (H3312-048) HMO

                        Premium and Other Important Information

                        • $6 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                        • $0 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

                        • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                        • $40 copay for each in-area network urgent care Medicare-covered visit
                        • $30 copay for each specialist visit for Medicare-covered benefits.
                        Independent Living Srvcs Of Central Ny Loretto Independent Living Services Inc (PACE) (H3321-001) National PACE
                          Independent Living Srvcs Of Central Ny Loretto Independent Living Services Inc (PACE) (H3321-003) National PACE
                            Fidelis Care Fidelis Medicare Advantage without Rx (HMO-POS) (H3328-001) HMO with POS Option

                              Premium and Other Important Information

                              • $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

                              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.
                              Fidelis Care Fidelis Dual Advantage (HMO SNP) (H3328-002) 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 $8 copay 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.*
                                Fidelis Care Fidelis Medicare Advantage Flex (HMO-POS) (H3328-003) HMO with POS Option

                                  Premium and Other Important Information

                                  • $6 700 out-of-pocket limit for Medicare-covered services.
                                  • $750 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply.
                                  • $39.8 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

                                  • $5 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.
                                  Fidelis Care Fidelis Dual Advantage Flex (HMO SNP) (H3328-013) 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
                                    • $0 annual deductible.*
                                    • ** 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. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                    • $400 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply.
                                    • $0 monthly plan premium*

                                    Doctor Office Visits

                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                    • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                    • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                    Excellus Health Plan Inc Medicare Blue PPO Plan TWO (PPO) (H3335-014) Local Preferred Provider Organization

                                      Premium and Other Important Information

                                      • $3 500 out-of-pocket limit. All plan services included.
                                      • $10 000 out-of-pocket limit. All plan services included.
                                      • $60 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
                                      Excellus Health Plan Inc Medicare Blue PPO Plan THREE (PPO) (H3335-015) Local Preferred Provider Organization

                                        Premium and Other Important Information

                                        • $3 500 out-of-pocket limit. All plan services included.
                                        • $10 000 out-of-pocket limit. All plan services included.
                                        • $110 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

                                        • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                        • $25 copay for each in-area network urgent care Medicare-covered visit
                                        • $25 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
                                        Excellus Health Plan Inc Medicare Blue PPO Plan ONE (PPO) (H3335-038) Local Preferred Provider Organization

                                          Premium and Other Important Information

                                          • $4 000 out-of-pocket limit. All plan services included.
                                          • $10 000 out-of-pocket limit. All plan services included.
                                          • $0 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.
                                          • $40 copay for each in-area network urgent care Medicare-covered visit
                                          • $40 copay for each specialist visit for Medicare-covered benefits.
                                          • $20 copay for each primary care doctor visit
                                          • $45 copay for each specialist visit
                                          Excellus Health Plan Inc Medicare Blue PPO Plan FOUR (PPO) (H3335-043) Local Preferred Provider Organization

                                            Premium and Other Important Information

                                            • $4 000 out-of-pocket limit. All plan services included.
                                            • $10 000 out-of-pocket limit. All plan services included.
                                            • $40.00 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

                                            • $20 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.
                                            • $25 copay for each primary care doctor visit
                                            • $35 copay for each specialist visit
                                            WellCare WellCare Liberty (HMO SNP) (H3361-043) 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
                                              • $0 annual deductible.*
                                              • ** 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. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                              • $0 monthly plan premium*

                                              Doctor Office Visits

                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                              • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                              • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                              WellCare WellCare Advance (HMO) (H3361-059) HMO

                                                Premium and Other Important Information

                                                • $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

                                                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.
                                                WellCare WellCare Access (HMO SNP) (H3361-065) 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
                                                  • $0 annual deductible.*
                                                  • ** 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. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                                  • $0 monthly plan premium*

                                                  Doctor Office Visits

                                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                  • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                  • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                  WellCare WellCare Value (HMO-POS) (H3361-099) HMO with POS Option

                                                    Premium and Other Important Information

                                                    • $6 700 out-of-pocket limit for Medicare-covered services.
                                                    • $0 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

                                                    • $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.
                                                    WellCare WellCare Choice (HMO-POS) (H3361-129) HMO with POS Option

                                                      Premium and Other Important Information

                                                      • $6 700 out-of-pocket limit for Medicare-covered services.
                                                      • $0 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 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.
                                                      UnitedHealthcare UnitedHealthcare Nursing Home Plan (HMO SNP) (H3379-022) HMO

                                                        Premium and Other Important Information

                                                        • $3 500 out-of-pocket limit for Medicare-covered services.
                                                        • $39.8 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

                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                        • 20% of the cost for each in-area network urgent care Medicare-covered visit
                                                        • 0% to 20% of the cost for each specialist visit for Medicare-covered benefits.
                                                        Northeast Community Care Northeast Community Care - Plus (HMO) (H3533-001) HMO

                                                          Premium and Other Important Information

                                                          • $6 700 out-of-pocket limit for Medicare-covered services.
                                                          • $19 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

                                                          • Authorization rules may apply.
                                                          • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                                          • $35 copay for each specialist visit for Medicare-covered benefits.
                                                          Northeast Community Care Northeast Community Care - Dual Plus (HMO SNP) (H3533-002) 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
                                                            • $0 annual deductible.*
                                                            • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                            • $3 400 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                                            • $0 monthly plan premium*

                                                            Doctor Office Visits

                                                            • Authorization rules may apply.
                                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                            • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                            • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                            Aetna Medicare Aetna Medicare Standard Plan (PPO) (H5521-040) Local Preferred Provider Organization

                                                              Premium and Other Important Information

                                                              • $6 700 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                                                              • $1 000 annual deductible. Contact the plan for services that apply.
                                                              • $10 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                                                              • $85 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

                                                              • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                                              • $40 copay for each in-area network urgent care Medicare-covered visit
                                                              • $25 copay for each specialist visit for Medicare-covered benefits.
                                                              • 40% of the cost for each primary care doctor visit
                                                              • 40% of the cost for each specialist visit
                                                              Humana Insurance Company of New York HumanaChoice H5970-002 (PPO) (H5970-002) Local Preferred Provider Organization

                                                                Premium and Other Important Information

                                                                • Package: 1 - MyOption Enhanced Dental PPO:
                                                                • Package: 2 - MyOption Healthy Back:
                                                                • $36 monthly premium in addition to your $19 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                                • $16 monthly premium in addition to your $19 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
                                                                • $500 plan coverage limit every year for these benefits.
                                                                • $4 000 out-of-pocket limit for Medicare-covered services.
                                                                • $6 000 out-of-pocket limit for Medicare-covered services.
                                                                • $19 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

                                                                • $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.
                                                                • 20% of the cost for each primary care doctor visit
                                                                • 20% of the cost for each specialist visit
                                                                Humana Insurance Company of New York Humana Reader's Digest Healthy Living Plan (PPO) (H5970-004) Local Preferred Provider Organization

                                                                  Premium and Other Important Information

                                                                  • Package: 1 - MyOption Enhanced Dental PPO:
                                                                  • Package: 2 - MyOption Healthy Back:
                                                                  • $36 monthly premium in addition to your $119 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                                  • $16 monthly premium in addition to your $119 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
                                                                  • $500 plan coverage limit every year for these benefits.
                                                                  • $5 000 out-of-pocket limit for Medicare-covered services.
                                                                  • $7 500 out-of-pocket limit for Medicare-covered services.
                                                                  • $119 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

                                                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                  • $0 copay for each in-area network urgent care Medicare-covered visit
                                                                  • $0 copay for each specialist visit for Medicare-covered benefits.
                                                                  • $0 copay for each primary care doctor visit
                                                                  • $0 copay for each specialist visit
                                                                  MVP HEALTH CARE GoldAnywhere Rx (PPO) (H9615-002) Local Preferred Provider Organization

                                                                    Premium and Other Important Information

                                                                    • $2 000 out-of-pocket limit for Medicare-covered services.
                                                                    • $5 000 out-of-pocket limit for Medicare-covered services.
                                                                    • $138.4 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
                                                                    • 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

                                                                    • Authorization rules may apply.
                                                                    • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                    • $15 copay for each in-area network urgent care Medicare-covered visit
                                                                    • $15 copay for each specialist visit for Medicare-covered benefits.
                                                                    • $35 copay for each primary care doctor visit
                                                                    • $35 copay for each specialist visit
                                                                    ActiveSaver MSA or BlueSaver MSA ActiveSaver MSA (MSA) (H9788-003) Medical Savings Account

                                                                      Premium and Other Important Information

                                                                      • Balance billing means that a provider may charge and bill you more than the plan's payment amount for services There is a limit on what providers may charge for Medicare-covered services
                                                                      • $4 950 annual deductible
                                                                      • Note that only Medicare-covered services will count toward your annual deductible.
                                                                      • Medicare will deposit $3 200 into your bank account.
                                                                      • You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan.
                                                                      • 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
                                                                      • Balance billing counts towards your plan deductible.

                                                                      Doctor Office Visits

                                                                      • Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met.
                                                                      MVP HEALTH CARE Preferred Gold (HMO-POS) (H9859-001) HMO with POS Option

                                                                        Premium and Other Important Information

                                                                        • $3 800 out-of-pocket limit for Medicare-covered services.
                                                                        • $14.60 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

                                                                        • Authorization rules may apply.
                                                                        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                        • $25 copay for each in-area network urgent care Medicare-covered visit
                                                                        • $25 copay for each specialist visit for Medicare-covered benefits.
                                                                        MVP HEALTH CARE Preferred Gold Rx (HMO-POS) (H9859-002) HMO with POS Option

                                                                          Premium and Other Important Information

                                                                          • $3 800 out-of-pocket limit for Medicare-covered services.
                                                                          • $72.1 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

                                                                          • Authorization rules may apply.
                                                                          • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                          • $25 copay for each in-area network urgent care Medicare-covered visit
                                                                          • $25 copay for each specialist visit for Medicare-covered benefits.
                                                                          MVP HEALTH CARE GoldValue Rx (HMO-POS) (H9859-013) HMO with POS Option

                                                                            Premium and Other Important Information

                                                                            • $4 600 out-of-pocket limit for Medicare-covered services.
                                                                            • $46.2 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

                                                                            • Authorization rules may apply.
                                                                            • $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.

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