3

3 out of 5 stars* for plan year 2024

Plan ID: H1350-006

What You Need to Know:

  • True Blue no Rx (HMO) is a Medicare Advantage Health Maintenance Organization Local HMO * plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $29, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is no drug coverage.
  • The plan includes an out-of-pocket maximum of $3,000 per year (in-network).
  • True Blue no Rx (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is no drug coverage.
  • This plan's Part D Initial Coverage Limit is .

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$29

Monthly Premium

Medicare Plan Features
Monthly Premium: $29.00
Part C Premium: NULL
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$29.00 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local HMO *
Similar Plan: H1350-015
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $3,000
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Payette, Idaho: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
106 members 3.5 out of 5 Stars. 3 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: NULL
Plan Health Benefits
Total # of Formulary Drugs: NULL
Number of Members Enrolled in this Plan in Payette, Idaho: NULL
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
NULL NULL NULL NULL
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
NULL NULL NULL NULL NULL NULL NULL
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
NULL NULL NULL NULL NULL NULL NULL NULL NULL NULL

Other Medicare Advantage Plans in Payette, Idaho

Plan Name Type Premium MOOP Rx Deduct. Rating
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$5,400$-
5
PacificSource Medicare MyCare Choice Rx 24 (HMO-POS) (2023)Local HMO$5,500$100
3
PacificSource Medicare Explorer 6 (PPO) (2023)Local PPO *$3,500$-
4
Humana Honor (PPO) (2023)Local PPO *$5,000$-
4
MediGold Medical Only (HMO) (2023)Local HMO *$3,900$-
New plan - not yet rated.
UnitedHealthcare Medicare Advantage Assure (PPO) (2023)Local PPO$7,550$445
5
MediGold Essential Care (HMO) (2023)Local HMO$5,500$0
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SelectHealth Advantage (HMO) (2023)Local HMO$6,700$200
2
MediGold True Advantage (HMO) (2023)Local HMO$4,500$0
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MediGold Classic Preferred (HMO) (2023)Local HMO$3,900$0
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AARP Medicare Advantage (HMO) (2023)Local HMO$4,900$200
5
True Blue Rx Option I (HMO) (2023)Local HMO$6,500$0
3
AARP Medicare Advantage Focus (HMO) (2023)Local HMO$4,900$100
5
Aetna Medicare Elite Plan (HMO) (2023)Local HMO$6,900$0
New plan - not yet rated.
Aetna Medicare Value Plan (HMO) (2023)Local HMO$7,550$0
New plan - not yet rated.
True Blue Rx Option II (HMO) (2023)Local HMO$6,400$250
3
Humana Community (HMO) (2023)Local HMO$5,500$100
5
HumanaChoice H5216-044 (PPO) (2023)Local PPO$6,000$200
4
HumanaChoice H5216-132 (PPO) (2023)Local PPO$5,500$200
4
Humana Gold Plus H5619-077 (HMO) (2023)Local HMO$5,000$150
4
True Blue Rx (HMO) (2023)Local HMO$6,200$125
3
Aetna Medicare Select Plan (PPO) (2023)Local PPO$7,000$0
5
Aetna Medicare Choice Plan (PPO) (2023)Local PPO$7,550$0
5
True Blue Rx Gem (HMO) (2023)Local HMO$5,800$190
3
Medicare Advantage Plans by Blue Cross of Idaho
True Blue Rx Option I (HMO) (2023)Local HMO$6,500$0
3
True Blue Rx Option II (HMO) (2023)Local HMO$6,400$250
3
True Blue Rx (HMO) (2023)Local HMO$6,200$125
3
True Blue Rx Gem (HMO) (2023)Local HMO$5,800$190
3

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