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Ohio MedicareAdvantage Plans

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Medicare Advantage Plans in Stark County, Ohio

Below are Medicare Advantage plans available to residents of Stark county, Ohio. 12 carriers offer 36 plans throughout the county of Stark. Residents may choose plans from carriers such as WellCare, Advantage by Buckeye Community Health Plan and UnitedHealthcare. 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 Stark county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Stark

Carrier Plan Title Plan Type
WellCare WellCare Value (HMO) (H0117-005) HMO

    Premium and Other Important Information

    • $3 600 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

    • $5 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) (H0117-007) 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.*
      Advantage by Buckeye Community Health Plan Advantage by Buckeye Community Health Plan (HMO SNP) (H0908-001) 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.
        • $3 400 out-of-pocket limit. All plan services included.*
        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

        Doctor Office Visits

        • Authorization rules may apply.
        • 0% or 0% to 20% of the cost for each primary care doctor visit for Medicare-covered benefits.*
        • 0% or 0% to 20% of the cost for each specialist visit for Medicare-covered benefits.*
        UnitedHealthcare UnitedHealthcare Nursing Home Plan (PPO SNP) (H2406-001) Local Preferred Provider Organization

          Premium and Other Important Information

          • $5 000 out-of-pocket limit for Medicare-covered services.
          • $10 000 out-of-pocket limit for Medicare-covered services.
          • $29.4 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

          • $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.
          • 30% of the cost for each primary care doctor visit
          • 30% of the cost for each specialist visit
          Humana Insurance Company HumanaChoice H3619-014 (PPO) (H3619-014) Local Preferred Provider Organization

            Premium and Other Important Information

            • Package: 1 - MyOption Enhanced Dental PPO:
            • Package: 2 - MyOption Healthy Back:
            • $23 monthly premium in addition to your $18 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 $18 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.
            • $4 800 out-of-pocket limit for Medicare-covered services.
            • $1 000 annual deductible. Contact the plan for services that apply.
            • $7 200 out-of-pocket limit for Medicare-covered services.
            • $18 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.
            • 30% of the cost for each primary care doctor visit
            • 30% of the cost for each specialist visit
            PrimeTime Health Plan PrimeTime Health Plan Prime PPO (PPO) (H3620-001) Local Preferred Provider Organization

              Premium and Other Important Information

              • Package: 1 - Dental and Vision:
              • $13.90 monthly premium in addition to your $121 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Eye Exams Eye Wear
              • $3 400 out-of-pocket limit. All plan services included.
              • $5 100 out-of-pocket limit. All plan services included.
              • $121 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
              • $35 copay for each specialist visit for Medicare-covered benefits.
              • $30 copay for each primary care doctor visit
              • $60 copay for each specialist visit
              Anthem Blue Cross and Blue Shield Anthem Senior Advantage Basic (HMO) (H3655-013) HMO

                Premium and Other Important Information

                • Package: 1 - Preventive Dental Package:
                • Package: 2 - Comprehensive Dental and Vision Package:
                • Package: 3 - Combination Package:
                • $12 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                • $31 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
                • $44 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh
                • $3 400 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

                • $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.
                Anthem Blue Cross and Blue Shield Anthem Senior Advantage Plus (HMO) (H3655-030) HMO

                  Premium and Other Important Information

                  • $3 000 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

                  Doctor Office Visits

                  • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                  • $20 copay for each in-area network urgent care Medicare-covered visit
                  • $20 copay for each specialist visit for Medicare-covered benefits.
                  UnitedHealthcare AARP MedicareComplete Plan 1 (HMO) (H3659-003) HMO

                    Premium and Other Important Information

                    • Package: 1 - Deluxe Rider:
                    • $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 Eye Exams Eye Wear
                    • $3 350 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.
                    • $30 copay for each in-area network urgent care Medicare-covered visit
                    • $35 copay for each specialist visit for Medicare-covered benefits.
                    UnitedHealthcare AARP MedicareComplete Plan 2 (HMO) (H3659-031) HMO

                      Premium and Other Important Information

                      • Package: 1 - Deluxe Rider:
                      • $38 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
                      • $4 300 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

                      • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                      • $30 copay for each in-area network urgent care Medicare-covered visit
                      • $35 copay for each specialist visit for Medicare-covered benefits.
                      UnitedHealthcare AARP MedicareComplete Essential (HMO) (H3659-054) HMO

                        Premium and Other Important Information

                        • Package: 1 - Deluxe Rider:
                        • Package: 2 - Fitness Rider:
                        • $38 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
                        • $13 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
                        • $3 650 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.
                        • $30 copay for each in-area network urgent care Medicare-covered visit
                        • $35 copay for each specialist visit for Medicare-covered benefits.
                        UnitedHealthcare UnitedHealthcare Dual Complete (HMO SNP) (H3659-056) 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.*
                          • $23.5 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.*
                          SummaCare Secure SummaCare Secure Gold (HMO-POS) (H3660-028) HMO with POS Option

                            Premium and Other Important Information

                            • $3 000 out-of-pocket limit for Medicare-covered services.
                            • $120 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.
                            • $40 copay for each in-area network urgent care Medicare-covered visit
                            • $25 copay for each specialist visit for Medicare-covered benefits.
                            SummaCare Secure SummaCare Secure Silver (HMO-POS) (H3660-029) HMO with POS Option

                              Premium and Other Important Information

                              • $3 400 out-of-pocket limit for Medicare-covered services.
                              • $30 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.
                              • $40 copay for each in-area network urgent care Medicare-covered visit
                              • $40 copay for each specialist visit for Medicare-covered benefits.
                              SummaCare Secure SummaCare Secure Platinum (HMO-POS) (H3660-032) HMO with POS Option

                                Premium and Other Important Information

                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                • $278 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
                                • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                SummaCare Secure SummaCare Secure Classic (HMO-POS) (H3660-043) HMO with POS Option

                                  Premium and Other Important Information

                                  • $3 400 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

                                  • $0 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.
                                  SummaCare Secure SummaCare Secure Core (HMO) (H3660-044) HMO

                                    Premium and Other Important Information

                                    • $3 400 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.
                                    • $40 copay for each in-area network urgent care Medicare-covered visit
                                    • $45 copay for each specialist visit for Medicare-covered benefits.
                                    PrimeTime Health Plan PrimeTime Health Plan Premier (HMO-POS) (H3664-012) HMO with POS Option

                                      Premium and Other Important Information

                                      • Package: 1 - Dental and Vision:
                                      • $13.90 monthly premium in addition to your $130 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Eye Exams Eye Wear POS option
                                      • $3 400 out-of-pocket limit. All plan services included.
                                      • $130 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
                                      • $35 copay for each specialist visit for Medicare-covered benefits.
                                      PrimeTime Health Plan PrimeTime Health Plan Basic - MA Only (HMO-POS) (H3664-014) HMO with POS Option

                                        Premium and Other Important Information

                                        • Package: 1 - Dental and Vision:
                                        • $13.90 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Eye Exams Eye Wear POS option
                                        • $3 400 out-of-pocket limit. All plan services included.
                                        • $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
                                        • $35 copay for each specialist visit for Medicare-covered benefits.
                                        PrimeTime Health Plan PrimeTime Health Plan Plus (HMO-POS) (H3664-017) HMO with POS Option

                                          Premium and Other Important Information

                                          • Package: 1 - Dental and Vision:
                                          • $13.90 monthly premium in addition to your $63 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Eye Exams Eye Wear POS option
                                          • $3 400 out-of-pocket limit. All plan services included.
                                          • $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

                                          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
                                          • $35 copay for each specialist visit for Medicare-covered benefits.
                                          PrimeTime Health Plan PrimeTime Health Plan Basic-Select (HMO-POS) (H3664-018) HMO with POS Option

                                            Premium and Other Important Information

                                            • Package: 1 - Dental and Vision:
                                            • $13.90 monthly premium in addition to your $35 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Eye Exams Eye Wear POS option
                                            • $3 400 out-of-pocket limit. All plan services included.
                                            • $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

                                            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.
                                            The Health Plan SecureCare - Option II (HMO) (H3672-013) HMO

                                              Premium and Other Important Information

                                              • $3 400 out-of-pocket limit. All plan services included.
                                              • $71 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.
                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                              • $35 copay for each in-area network urgent care Medicare-covered visit
                                              • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                              The Health Plan SecureCare - Option I (HMO) (H3672-014) HMO

                                                Premium and Other Important Information

                                                • $3 400 out-of-pocket limit. All plan services included.
                                                • $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

                                                • Authorization rules may apply.
                                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                • $35 copay for each in-area network urgent care Medicare-covered visit
                                                • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                                The Health Plan SecureCare - Option III (HMO) (H3672-016) HMO

                                                  Premium and Other Important Information

                                                  • $3 400 out-of-pocket limit. All plan services included.
                                                  • $112 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.
                                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                  • $35 copay for each in-area network urgent care Medicare-covered visit
                                                  • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                                  Universal Health Care Insurance Company Inc. Universal Hassle-Free (PPO) (H5096-001) Local Preferred Provider Organization

                                                    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
                                                    • 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 specialist visit for Medicare-covered benefits.
                                                    • $15 copay for each primary care doctor visit
                                                    • $40 copay for each specialist visit
                                                    Universal Health Care Insurance Company Inc. Universal Hassle-Free MA Only (PPO) (H5096-002) Local Preferred Provider Organization

                                                      Premium and Other Important Information

                                                      • Universal Health Care Insurance Company Inc. will reduce your monthly Medicare Part B premium by up to $ 10.00.
                                                      • $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
                                                      • 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 specialist visit for Medicare-covered benefits.
                                                      • $15 copay for each primary care doctor visit
                                                      • $40 copay for each specialist visit
                                                      Anthem Blue Cross and Blue Shield Anthem Medicare Preferred Standard (PPO) (H5529-001) Local Preferred Provider Organization

                                                        Premium and Other Important Information

                                                        • $4 500 out-of-pocket limit for Medicare-covered services.
                                                        • $39 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.
                                                        • $35 copay for each in-area network urgent care Medicare-covered visit
                                                        • $35 copay for each specialist visit for Medicare-covered benefits.
                                                        • $30 copay for each primary care doctor visit
                                                        • $45 copay for each specialist visit
                                                        Anthem Blue Cross and Blue Shield Anthem Medicare Preferred Select (PPO) (H5529-004) Local Preferred Provider Organization

                                                          Premium and Other Important Information

                                                          • $3 400 out-of-pocket limit for Medicare-covered services.
                                                          • $59 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.
                                                          • $20 copay for each in-area network urgent care Medicare-covered visit
                                                          • $20 copay for each specialist visit for Medicare-covered benefits.
                                                          • $15 copay for each primary care doctor visit
                                                          • $25 copay for each specialist visit
                                                          CareSource CareSource Advantage (HMO SNP) (H6178-001) 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. All plan services included.*
                                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                            Doctor Office Visits

                                                            • Authorization rules may apply.
                                                            • $0 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.*
                                                            Universal Health Care Insurance Company Inc. Any Any Any Gold (PFFS) (H8098-001) Private Fee for Service

                                                              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
                                                              • 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 specialist visit for Medicare-covered benefits.
                                                              • $15 copay for each primary care doctor visit
                                                              • $40 copay for each specialist visit
                                                              Universal Health Care Insurance Company Inc. Any Any Any Gold MA Only (PFFS) (H8098-003) Private Fee for Service

                                                                Premium and Other Important Information

                                                                • Universal Health Care Insurance Company Inc. will reduce your monthly Medicare Part B premium by up to $ 15.00.
                                                                • $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.
                                                                • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                • $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 Humana Gold Choice H8145-033 (PFFS) (H8145-033) 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 $89 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                                                  • $23 monthly premium in addition to your $89 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 $89 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.
                                                                  • $1 000 annual deductible. Contact the plan for services that apply.
                                                                  • $6 700 out-of-pocket limit for Medicare-covered services.
                                                                  • $89 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
                                                                  Health Plan SecureChoice SecureChoice - Option II (PPO) (H8604-001) Local Preferred Provider Organization

                                                                    Premium and Other Important Information

                                                                    • $3 400 out-of-pocket limit. All plan services included.
                                                                    • $250 annual deductible. Contact the plan for services that apply.
                                                                    • $111 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.
                                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                    • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                    • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                                                    • $20 to $45 copay for each primary care doctor visit
                                                                    • $45 copay for each specialist visit
                                                                    Health Plan SecureChoice SecureChoice - Option I (PPO) (H8604-002) Local Preferred Provider Organization

                                                                      Premium and Other Important Information

                                                                      • $3 400 out-of-pocket limit. All plan services included.
                                                                      • $250 annual deductible. Contact the plan for services that apply.
                                                                      • $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
                                                                      • 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.
                                                                      • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                      • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                      • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                                                      • $20 to $45 copay for each primary care doctor visit
                                                                      • $45 copay for each specialist visit
                                                                      Health Plan SecureChoice SecureChoice - Option III (PPO) (H8604-005) Local Preferred Provider Organization

                                                                        Premium and Other Important Information

                                                                        • $3 400 out-of-pocket limit. All plan services included.
                                                                        • $250 annual deductible. Contact the plan for services that apply.
                                                                        • $137 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.
                                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                        • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                        • $0 to $35 copay for each specialist visit for Medicare-covered benefits.
                                                                        • $20 to $45 copay for each primary care doctor visit
                                                                        • $45 copay for each specialist visit
                                                                        Humana Health Plan of Ohio Inc. Humana Gold Plus H8953-006 (HMO) (H8953-006) HMO

                                                                          Premium and Other Important Information

                                                                          • Package: 1 - MyOption Enhanced Dental HMO:
                                                                          • Package: 2 - MyOption Healthy Back:
                                                                          • $26 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
                                                                          • $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
                                                                          • $500 plan coverage limit every year for these benefits.
                                                                          • $3 950 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

                                                                          • Authorization rules may apply.
                                                                          • $10 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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