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Pennsylvania MedicareAdvantage Plans

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Medicare Advantage Plans in Erie County, Pennsylvania

Below are Medicare Advantage plans available to residents of Erie county, Pennsylvania. 11 carriers offer 41 plans throughout the county of Erie. Residents may choose plans from carriers such as Universal American Corp., UPMC Health Plan and Highmark Inc.. 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 Erie county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Erie

Carrier Plan Title Plan Type
Universal American Corp. Today's Options Advantage Plus 450G (PPO) (H2775-084) Local Preferred Provider Organization

    Premium and Other Important Information

    • $6 700 out-of-pocket limit for Medicare-covered services.
    • $36 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

    • $25 copay for each primary care doctor visit for Medicare-covered benefits.
    • $35 copay for each in-area network urgent care Medicare-covered visit
    • $50 copay for each specialist visit for Medicare-covered benefits.
    • $30 copay for each primary care doctor visit
    • $60 copay for each specialist visit
    Universal American Corp. Today's Options Advantage 400 (PPO) (H2775-096) Local Preferred Provider Organization

      Premium and Other Important Information

      • $6 700 out-of-pocket limit for Medicare-covered services.
      • $10.00 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

      • $25 copay for each primary care doctor visit for Medicare-covered benefits.
      • $35 copay for each in-area network urgent care Medicare-covered visit
      • $50 copay for each specialist visit for Medicare-covered benefits.
      • $30 copay for each primary care doctor visit
      • $60 copay for each specialist visit
      Universal American Corp. Today's Options Advantage Plus 150A (PPO) (H2775-098) Local Preferred Provider Organization

        Premium and Other Important Information

        • $3 400 out-of-pocket limit for Medicare-covered services.
        • $101 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 Premier 400 (PFFS) (H2816-009) Private Fee for Service

          Premium and Other Important Information

          • $6 700 out-of-pocket limit for Medicare-covered services.
          • $30.00 monthly plan premium in addition to your monthly Medicare Part B premium.
          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i
          • 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.
          • $25 copay for each primary care doctor visit for Medicare-covered benefits.
          • $35 copay for each in-area network urgent care Medicare-covered visit
          • $50 copay for each specialist visit for Medicare-covered benefits.
          • $30 copay for each primary care doctor visit
          • $60 copay for each specialist visit
          Universal American Corp. Today's Options Premier Plus 450H (PFFS) (H2816-021) Private Fee for Service

            Premium and Other Important Information

            • $6 700 out-of-pocket limit for Medicare-covered services.
            • $66 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.
            • $25 copay for each primary care doctor visit for Medicare-covered benefits.
            • $35 copay for each in-area network urgent care Medicare-covered visit
            • $50 copay for each specialist visit for Medicare-covered benefits.
            • $30 copay for each primary care doctor visit
            • $60 copay for each specialist visit
            Universal American Corp. Today's Options Premier 100 (PFFS) (H2816-025) Private Fee for Service

              Premium and Other Important Information

              • $3 400 out-of-pocket limit for Medicare-covered services.
              • $70.00 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 Plus 150A (PFFS) (H2816-027) Private Fee for Service

                Premium and Other Important Information

                • $3 400 out-of-pocket limit for Medicare-covered services.
                • $102 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
                UPMC Health Plan UPMC for Life (HMO) (H3907-002) HMO

                  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

                  • $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.
                  UPMC Health Plan UPMC for Life HMO Rx Enhanced (HMO) (H3907-006) HMO

                    Premium and Other Important Information

                    • $3 200 out-of-pocket limit for Medicare-covered services.
                    • $196.5 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.
                    • $20 copay for each in-area network urgent care Medicare-covered visit
                    • $20 copay for each specialist visit for Medicare-covered benefits.
                    UPMC Health Plan UPMC for Life HMO Rx (HMO) (H3907-029) HMO

                      Premium and Other Important Information

                      • $3 400 out-of-pocket limit for Medicare-covered services.
                      • $69.5 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
                      • $40 copay for each specialist visit for Medicare-covered benefits.
                      UPMC Health Plan UPMC for Life Specialty Plan (HMO SNP) (H3907-034) 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

                        • $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.*
                        Highmark Inc. FreedomBlue PPO Classic (PPO) (H3916-002) Local Preferred Provider Organization

                          Premium and Other Important Information

                          • $3 400 out-of-pocket limit for Medicare-covered services.
                          • $500 annual deductible. Contact the plan for services that apply.
                          • $5 100 out-of-pocket limit for Medicare-covered services.
                          • $166 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.
                          • $50 copay for each in-area network urgent care Medicare-covered visit
                          • $25 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
                          Highmark Inc. FreedomBlue PPO HD Rx (PPO) (H3916-020) Local Preferred Provider Organization

                            Premium and Other Important Information

                            • Highmark Inc. will reduce your monthly Medicare Part B premium by up to $ 3.00.
                            • $2 750 out-of-pocket limit for Medicare-covered services.
                            • $1 000 annual deductible. Contact the plan for services that apply.
                            • $4 500 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

                            • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                            • $50 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
                            Highmark Inc. FreedomBlue PPO Select (PPO) (H3916-024) Local Preferred Provider Organization

                              Premium and Other Important Information

                              • $3 400 out-of-pocket limit for Medicare-covered services.
                              • $500 annual deductible. Contact the plan for services that apply.
                              • $5 100 out-of-pocket limit for Medicare-covered services.
                              • $73 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.
                              • $50 copay for each in-area network urgent care Medicare-covered visit
                              • $30 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
                              UnitedHealthcare UnitedHealthcare MedicareComplete (HMO) (H3920-001) HMO

                                Premium and Other Important Information

                                • Package: 1 - Dental Platinum Rider:
                                • $33 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
                                • $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

                                • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                                • $30 copay for each in-area network urgent care Medicare-covered visit
                                • $45 copay for each specialist visit for Medicare-covered benefits.
                                UnitedHealthcare UnitedHealthcare Dual Complete (HMO SNP) (H3920-009) 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.*
                                  UnitedHealthcare AARP MedicareComplete Choice (PPO) (H3921-008) Local Preferred Provider Organization

                                    Premium and Other Important Information

                                    • Package: 1 - Dental Platinum Rider:
                                    • $33 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
                                    • $4 900 out-of-pocket limit for Medicare-covered services.
                                    • $9 900 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

                                    • $10 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.
                                    • $20 copay for each primary care doctor visit
                                    • $40 copay for each specialist visit
                                    Keystone Health Plan West Inc. SecurityBlue Standard (HMO) (H3957-006) HMO

                                      Premium and Other Important Information

                                      • $3 400 out-of-pocket limit for Medicare-covered services.
                                      • $152 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.
                                      • $50 copay for each in-area network urgent care Medicare-covered visit
                                      • $25 copay for each specialist visit for Medicare-covered benefits.
                                      Keystone Health Plan West Inc. SecurityBlue Deluxe (HMO) (H3957-021) HMO

                                        Premium and Other Important Information

                                        • $3 400 out-of-pocket limit for Medicare-covered services.
                                        • $189 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.
                                        • $50 copay for each in-area network urgent care Medicare-covered visit
                                        • $25 copay for each specialist visit for Medicare-covered benefits.
                                        Keystone Health Plan West Inc. SecurityBlue Value (HMO) (H3957-025) HMO

                                          Premium and Other Important Information

                                          • $3 400 out-of-pocket limit for Medicare-covered services.
                                          • $25.00 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.
                                          • $50 copay for each in-area network urgent care Medicare-covered visit
                                          • $30 copay for each specialist visit for Medicare-covered benefits.
                                          Keystone Health Plan West Inc. SecurityBlue Care (HMO SNP) (H3957-030) 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 for Medicare-covered services.*
                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                            Doctor Office Visits

                                            • 0% or 20% of the cost for each primary care doctor visit for Medicare-covered benefits.*
                                            • 0% or 20% of the cost for each in-area network urgent care Medicare-covered visit*
                                            • 0% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
                                            Keystone Health Plan West Inc. SecurityBlue ValueRx (HMO) (H3957-032) HMO

                                              Premium and Other Important Information

                                              • $3 400 out-of-pocket limit for Medicare-covered services.
                                              • $38 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.
                                              • $50 copay for each in-area network urgent care Medicare-covered visit
                                              • $40 copay for each specialist visit for Medicare-covered benefits.
                                              Keystone Health Plan West Inc. SecurityBlue HD (HMO) (H3957-037) HMO

                                                Premium and Other Important Information

                                                • Keystone Health Plan West Inc. will reduce your monthly Medicare Part B premium by up to $ 3.00.
                                                • $1 000 annual deductible. Contact the plan for services that apply.
                                                • $2 750 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.
                                                • $50 copay for each in-area network urgent care Medicare-covered visit
                                                • $25 copay for each specialist visit for Medicare-covered benefits.
                                                HealthAmerica Advantra Gold (HMO) (H3959-002) HMO

                                                  Premium and Other Important Information

                                                  • $4 300 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

                                                  Doctor Office Visits

                                                  • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                                  • $50 copay for each in-area network urgent care Medicare-covered visit
                                                  • $35 copay for each specialist visit for Medicare-covered benefits.
                                                  HealthAmerica Advantra Silver (HMO) (H3959-011) HMO

                                                    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.
                                                    • $50 copay for each in-area network urgent care Medicare-covered visit
                                                    • $35 copay for each specialist visit for Medicare-covered benefits.
                                                    HealthAmerica Advantra Silver Plus (HMO) (H3959-032) HMO

                                                      Premium and Other Important Information

                                                      • $4 300 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

                                                      • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                                      • $50 copay for each in-area network urgent care Medicare-covered visit
                                                      • $30 copay for each specialist visit for Medicare-covered benefits.
                                                      UPMC for You Advantage UPMC for You Advantage (HMO SNP) (H4279-001) 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
                                                        • $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

                                                        • $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.*
                                                        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
                                                            HealthAmerica Advantra Silver (PPO) (H5522-005) Local Preferred Provider Organization

                                                              Premium and Other Important Information

                                                              • $5 900 out-of-pocket limit for Medicare-covered services.
                                                              • $1 500 annual deductible. Contact the plan for services that apply.
                                                              • $10 000 out-of-pocket limit for Medicare-covered services.
                                                              • $23 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
                                                              • $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
                                                              HealthAmerica Advantra Elite (PPO) (H5522-009) Local Preferred Provider Organization

                                                                Premium and Other Important Information

                                                                • $2 000 annual deductible. Contact the plan for services that apply.
                                                                • $6 550 out-of-pocket limit for Medicare-covered services.
                                                                • $150 plan coverage limit every year for Non-Medicare Supplemental benefits. Contact the plan for services that apply.
                                                                • $10 000 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.
                                                                • $50 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
                                                                UPMC Health Plan UPMC for Life PPO High Deductible with Rx (PPO) (H5533-003) Local Preferred Provider Organization

                                                                  Premium and Other Important Information

                                                                  • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                  • $1 250 annual deductible. Contact the plan for services that apply.
                                                                  • $5 100 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

                                                                  • $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
                                                                  • $50 copay for each specialist visit
                                                                  UPMC Health Plan UPMC for Life PPO Rx (PPO) (H5533-004) Local Preferred Provider Organization

                                                                    Premium and Other Important Information

                                                                    • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                    • $500 annual deductible. Contact the plan for services that apply.
                                                                    • $5 100 out-of-pocket limit for Medicare-covered services.
                                                                    • $81.5 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.
                                                                    • $30 copay for each in-area network urgent care Medicare-covered visit
                                                                    • $30 copay for each specialist visit for Medicare-covered benefits.
                                                                    • $30 copay for each primary care doctor visit
                                                                    • $50 copay for each specialist visit
                                                                    Gateway Health Plan Medicare Assured Gateway Health Plan Medicare Assured (HMO SNP) (H5932-001) 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
                                                                      • $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

                                                                      • $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.*
                                                                      Humana Insurance Company HumanaChoice H6900-002 (PPO) (H6900-002) Local Preferred Provider Organization

                                                                        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 $19 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                                                        • $31 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
                                                                        • $290 plan coverage limit every year for these benefits.
                                                                        • $500 plan coverage limit every year for these benefits.
                                                                        • $6 700 out-of-pocket limit for Medicare-covered services.
                                                                        • $10 000 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.
                                                                        • 30% of the cost for each primary care doctor visit
                                                                        • 30% of the cost for each specialist visit
                                                                        Humana Insurance Company HumanaChoice H6900-006 (PPO) (H6900-006) Local Preferred Provider Organization

                                                                          Premium and Other Important Information

                                                                          • Package: 1 - MyOption Enhanced Dental:
                                                                          • Package: 2 - MyOption Healthy Back:
                                                                          • $31 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.
                                                                          • $1 000 annual deductible. Contact the plan for services that apply.
                                                                          • $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.
                                                                          • 30% of the cost for each primary care doctor visit
                                                                          • 30% of the cost for each specialist visit
                                                                          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 H8145-052 (PFFS) (H8145-052) Private Fee for Service

                                                                                Premium and Other Important Information

                                                                                • Package: 1 - MyOption Dental Low PPO:
                                                                                • Package: 2 - MyOption Vision:
                                                                                • Package: 3 - MyOption Plus:
                                                                                • Package: 4 - MyOption Complete:
                                                                                • Package: 5 - MyOption Healthy Back:
                                                                                • $20 monthly premium in addition to your $49 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 $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                                                                                • $31 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                                                                                • $33 monthly premium in addition to your $49 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 $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
                                                                                • $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.
                                                                                • $5 900 out-of-pocket limit for Medicare-covered services.
                                                                                • $49 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co
                                                                                • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                                                                Doctor Office Visits

                                                                                • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                                                                • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                                • $35 copay for each specialist visit for Medicare-covered benefits.
                                                                                • $15 copay for each primary care doctor visit
                                                                                • $35 copay for each specialist visit
                                                                                Humana Insurance Company Humana Gold Choice H8145-055 (PFFS) (H8145-055) Private Fee for Service

                                                                                  Premium and Other Important Information

                                                                                  • Package: 1 - MyOption Dental Low PPO:
                                                                                  • Package: 2 - MyOption Vision:
                                                                                  • Package: 3 - MyOption Plus:
                                                                                  • Package: 4 - MyOption Complete:
                                                                                  • Package: 5 - MyOption Healthy Back:
                                                                                  • $20 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
                                                                                  • $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
                                                                                  • $33 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
                                                                                  • $1 000 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.
                                                                                  • $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 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
                                                                                  Geisinger Gold Geisinger Gold Reserve (MSA) (H8468-001) 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
                                                                                    • $3 000 annual deductible
                                                                                    • Note that only Medicare-covered services will count toward your annual deductible.
                                                                                    • Medicare will deposit $1 500 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.

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