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Medicare Advantage Plans in York County, Pennsylvania

Below are Medicare Advantage plans available to residents of York county, Pennsylvania. 10 carriers offer 44 plans throughout the county of York. Residents may choose plans from carriers such as York County PACE, Universal American Corp. 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 York county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of York

Carrier	Plan Title	Plan Type
York County PACE	Senior LIFE York Dual Eligible (PACE) (H0819-001)	National PACE
York County PACE	Senior LIFE York Medicare Only (PACE) (H0819-002)	National PACE
Universal American Corp.	Today's Options Advantage Plus 150A (PPO) (H2775-083)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $90 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $35 copay for each specialist visit
Universal American Corp.	Today's Options Advantage Plus 650B (PPO) (H2775-089)	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 $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) (H2775-095)	Local Preferred Provider Organization
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i 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 Premier 100 (PFFS) (H2816-002)	Private Fee for Service
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $47.00 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 400 (PFFS) (H2816-008)	Private Fee for Service
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $0.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i 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 150A (PFFS) (H2816-014)	Private Fee for Service
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services. $100 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co This plan does not allow providers to balance bill (charging more than your cost share amount). Doctor Office Visits You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment. $10 copay for each primary care doctor visit for Medicare-covered benefits. $35 copay for each in-area network urgent care Medicare-covered visit $30 copay for each specialist visit for Medicare-covered benefits. $15 copay for each primary care doctor visit $35 copay for each specialist visit
Universal American Corp.	Today's Options Premier Plus 450B (PFFS) (H2816-020)	Private Fee for Service
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $35 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co 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
UnitedHealthcare	UnitedHealthcare Nursing Home Plan (PPO SNP) (H3912-001)	Local Preferred Provider Organization
Premium and Other Important Information $3 500 out-of-pocket limit for Medicare-covered services. $10 000 out-of-pocket limit for Medicare-covered services. $32.7 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
Highmark Inc.	FreedomBlue PPO Deluxe (PPO) (H3916-005)	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. $167 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 Value (PPO) (H3916-012)	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. $61.00 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. $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 Standard (PPO) (H3916-015)	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. $132 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 $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 Basic Rx (PPO) (H3916-018)	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. $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 $15 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. 30% of the cost for each primary care doctor visit 30% of the cost for each specialist visit
Highmark Inc.	FreedomBlue PPO HD Rx (PPO) (H3916-025)	Local Preferred Provider Organization
Premium and Other Important Information Highmark Inc. will reduce your monthly Medicare Part B premium by up to $ 3.00. $2 700 out-of-pocket limit for Medicare-covered services. $950 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 $5 copay for each primary care doctor visit for Medicare-covered benefits. $50 copay for each in-area network urgent care Medicare-covered visit $15 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	UnitedHealthcare MedicareComplete Choice (PPO) (H3921-001)	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
Capital Advantage Insurance Company	SeniorBlue - Option 2 (PPO) (H3923-013)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $500 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $42.1 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co 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 specialist visit for Medicare-covered benefits. 30% of the cost for each primary care doctor visit 30% of the cost for each specialist visit
Capital Advantage Insurance Company	SeniorBlue - Option 1 (PPO) (H3923-017)	Local Preferred Provider Organization
Premium and Other Important Information $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $500 annual deductible. Contact the plan for services that apply. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $162.7 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $25 copay for each specialist visit for Medicare-covered benefits. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 1 (PPO) (H3924-021)	Local Preferred Provider Organization
Premium and Other Important Information $195 annual deductible. Contact the plan for services that apply. $2 550 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $28.00 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 1 $0 Deductible Rx (PPO) (H3924-023)	Local Preferred Provider Organization
Premium and Other Important Information $195 annual deductible. Contact the plan for services that apply. $2 550 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $64 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. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits. $20 copay for each primary care doctor visit $35 copay for each specialist visit
Geisinger Gold	Geisinger Gold Preferred 2 (PPO) (H3924-045)	Local Preferred Provider Organization
Premium and Other Important Information $60 annual deductible. Contact the plan for services that apply. $3 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $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 $20 copay for each primary care doctor visit for Medicare-covered benefits. $20 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
Geisinger Gold	Geisinger Gold Preferred 2 $0 Deductible Rx (PPO) (H3924-046)	Local Preferred Provider Organization
Premium and Other Important Information $60 annual deductible. Contact the plan for services that apply. $3 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $5 100 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $40 monthly plan premium in addition to your monthly Medicare Part B premium. Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay 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. $20 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
Bravo Health	Bravo Classic (HMO) (H3949-002)	HMO
Premium and Other Important Information Package: 1 - Enhanced Hearing and Dental: $36.30 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 Hearing Exams Hea $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 $5 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.
Bravo Health	Bravo Select (HMO SNP) (H3949-009)	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 ** 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.* $34.3 monthly plan premium in addition to your monthly Medicare Part B premium.* Doctor Office Visits $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.*
Bravo Health	Bravo Traditions (HMO SNP) (H3949-016)	HMO
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $34.3 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. $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.
Bravo Health	Bravo Achieve (HMO SNP) (H3949-024)	HMO
Premium and Other Important Information Package: 1 - Enhanced Hearing and Dental: $36.30 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 Hearing Exams Hea $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 $5 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.
Geisinger Gold	Geisinger Gold Classic 1 (HMO) (H3954-007)	HMO
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $112.00 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. $10 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Classic 1 $0 Deductible Rx (HMO) (H3954-033)	HMO
Premium and Other Important Information $2 800 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $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 Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $20 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Secure 1 (HMO SNP) (H3954-097)	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 ** 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.* $34.3 monthly plan premium in addition to your monthly Medicare Part B 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% or 20% of the cost for each specialist visit for Medicare-covered benefits.*
Geisinger Gold	Geisinger Gold Classic 3 (HMO) (H3954-098)	HMO
Premium and Other Important Information $1 300 annual deductible. Contact the plan for services that apply. $1 500 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $0.00 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. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Classic 3 $0 Deductible Rx (HMO) (H3954-100)	HMO
Premium and Other Important Information $1 300 annual deductible. Contact the plan for services that apply. $1 500 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $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 Doctor Office Visits $10 copay for each primary care doctor visit for Medicare-covered benefits. $10 copay for each in-area network urgent care Medicare-covered visit $25 copay for each specialist visit for Medicare-covered benefits.
Geisinger Gold	Geisinger Gold Secure 3 (HMO SNP) (H3954-135)	HMO
Premium and Other Important Information $2 000 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit. $118 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. $5 copay for each in-area network urgent care Medicare-covered visit $30 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 Gold (PPO) (H5522-002)	Local Preferred Provider Organization
Premium and Other Important Information $4 300 out-of-pocket limit for Medicare-covered services. $750 annual deductible. Contact the plan for services that apply. $1 150 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. $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 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 $5 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. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit
HealthAmerica	Advantra Silver (PPO) (H5522-004)	Local Preferred Provider Organization
Premium and Other Important Information $6 700 out-of-pocket limit for Medicare-covered services. $1 000 annual deductible. 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 $10 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. 20% of the cost for each primary care doctor visit 20% of the cost for each specialist visit
HealthAmerica	Advantra Elite (PPO) (H5522-008)	Local Preferred Provider Organization
Premium and Other Important Information $1 500 annual deductible. Contact the plan for services that apply. $6 400 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
HealthAmerica	Advantra Silver Plus (PPO) (H5522-013)	Local Preferred Provider Organization
Premium and Other Important Information $4 700 out-of-pocket limit for Medicare-covered services. $750 annual deductible. Contact the plan for services that apply. $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. $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 $5 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. 20% of the cost for each primary care doctor visit 20% of the cost 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 H6900-004 (PPO) (H6900-004)	Local Preferred Provider Organization
Premium and Other Important Information Package: 1 - MyOption Enhanced Dental PPO: Package: 2 - MyOption Healthy Back: $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 $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	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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