Plan ID: H3071-003

What You Need to Know:

  • Clear Spring Health Community Flex Plan (HMO-POS) 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 $19, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $3,950 per year (in-network).
  • Clear Spring Health Community Flex Plan (HMO-POS) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $19.

$19

Monthly Premium

Medicare Plan Features
Monthly Premium: $19.00
Part C Premium: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$19.00 $0 $19.00 $0 $19.00 $0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H3071-002
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $3,950
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Winnebago, Illinois: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
610 members 3 out of 5 Stars. Insufficient data to rate this plan. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,276 drugs
Number of Members Enrolled in this Plan in Winnebago, Illinois: 1,155 members
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
$0.00 $19.00 $0.00 $19.00
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
$0.00 $14.20 $14.20 $9.50 $9.50 $4.70 $4.70
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)
341 $0.00 543 $12.00 934 $42.00 795 $95.00 663 33%

Other Medicare Advantage Plans in Winnebago, Illinois

Plan Name Type Premium MOOP Rx Deduct. Rating
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Aetna Medicare Eagle (PPO) (2023)Local PPO *$5,900$-
5
Clear Spring Health Community Advantage Plan (HMO) (2023)Local HMO$3,950$0
Insufficient data to rate this plan.
Clear Spring Health Essential (HMO) (2023)Local HMO$2,900$0
New plan - not yet rated.
HumanaChoice H5216-251 (PPO) (2023)Local PPO$5,500$200
4
HumanaChoice H5525-004 (PPO) (2023)Local PPO$5,500$250
4
AARP Medicare Advantage Walgreens (PPO) (2023)Local PPO$5,900$250
5
Health Alliance Medicare HMO 40 Rx (HMO) (2023)Local HMO$4,700$0
4
Health Alliance Medicare POS 10 Rx (HMO-POS) (2023)Local HMO$4,500$0
4
Health Alliance Medicare HMO 20 Rx (HMO) (2023)Local HMO$4,000$0
4
Health Alliance Medicare POS Basic Rx (HMO-POS) (2023)Local HMO$6,700$0
4
Humana Gold Choice H8145-008 (PFFS) (2023)PFFS$-$380
4
Health Alliance Medicare HMO Basic (HMO) (2023)Local HMO *$6,700$-
4
UnitedHealthcare Medicare Advantage Assure (PPO) (2023)Local PPO$7,550$445
5
WellCare Essential (HMO) (2023)Local HMO$3,450$0
5
Aetna Medicare Explorer Value (PPO) (2023)Local PPO$5,900$0
5
AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$5,900$-
5
WellCare Edge (HMO) (2023)Local HMO$3,450$445
5
Health Alliance Medicare POS Basic (HMO-POS) (2023)Local HMO *$6,700$-
4
OSF MedAdvantage Core (HMO) (2023)Local HMO$4,000$0
4
Aetna Medicare Premier Advantra (PPO) (2023)Local PPO$5,500$0
5
OSF MedAdvantage Open (HMO-POS) (2023)Local HMO$4,500$0
4
Aetna Medicare Value Advantra (PPO) (2023)Local PPO$5,900$0
5
Health Alliance Medicare POS 30 Rx (HMO-POS) (2023)Local HMO$5,500$0
4
Health Alliance Medicare HMO Basic Rx (HMO) (2023)Local HMO$6,700$0
4
OSF MedAdvantage Plus (HMO-POS) (2023)Local HMO$3,400$0
4
Humana Gold Plus H1468-007 (HMO) (2023)Local HMO$3,900$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
HumanaChoice R5361-001 (Regional PPO) (2023)Regional PPO *$6,700$-
5
AARP Medicare Advantage (HMO-POS) (2023)Local HMO$3,900$0
5
OSF MedAdvantage Select (HMO) (2023)Local HMO$3,400$0
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,400$0
5
Zing Choice IL (HMO) (2023)Local HMO$2,950$0
New plan - not yet rated.
HumanaChoice R5361-002 (Regional PPO) (2023)Regional PPO$6,700$420
5
Zing Open Access IL (HMO-POS) (2023)Local HMO$3,500$0
New plan - not yet rated.
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
SwedishAmerican Quartz Med Advantage Value (HMO) (2023)Local HMO *$4,900$-
3
SwedishAmerican Quartz Med Advantage Elite (HMO) (2023)Local HMO *$3,450$-
3
Medicare Advantage Plans by Clear Spring Health
Clear Spring Health Community Advantage Plan (HMO) (2023)Local HMO$3,950$0
Insufficient data to rate this plan.
Clear Spring Health Essential (HMO) (2023)Local HMO$2,900$0
New plan - not yet rated.

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