5

5 out of 5 stars* for plan year 2024

Plan ID: H1248-001

What You Need to Know:

  • Blue Advantage (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO 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 $75, 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 $3,500 per year (in-network).
  • Blue Advantage (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $57.

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

$75

Monthly Premium

Medicare Plan Features
Monthly Premium: $75.00
Part C Premium: $17.80
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$75.00 $17.80 $57.20 $0 $57.20 $0 0.0
Gap Coverage: Yes
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H1248-002
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: Yes, some additional gap coverage.
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $3,500
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Iberville, Louisiana: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members New plan - No summary rating as of yet. 5 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,710 drugs
Number of Members Enrolled in this Plan in Iberville, Louisiana: 152 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
$17.80 $57.20 $0.00 $75.00
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
$40.70 $48.60 $66.40 $40.10 $57.90 $31.50 $49.30
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)
388 $3.00 1744 $12.00 428 $45.00 362 $100.00 788 33%

Other Medicare Advantage Plans in Iberville, Louisiana

Plan Name Type Premium MOOP Rx Deduct. Rating
Vantage STANDARD (HMO-POS) (2023)Local HMO$4,900$275
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HumanaChoice H5216-202 (PPO) (2023)Local PPO$6,700$400
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WellCare Premier (PPO) (2023)Local PPO$5,000$75
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Aetna Medicare Advantra Plan (HMO) (2023)Local HMO$5,900$150
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Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$6,900$-
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Wellcare Absolute (PPO) (2023)Local PPO$7,550$195
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Vantage PREMIUM (HMO-POS) (2023)Local HMO$3,500$0
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Aetna Medicare Freedom Plan (PPO) (2023)Local PPO$7,550$195
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Allwell Medicare (HMO) (2023)Local HMO$7,550$0
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HumanaChoice R0110-003 (Regional PPO) (2023)Regional PPO$7,550$400
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Humana-Ochsner Network H1951-039 (HMO) (2023)Local HMO$3,700$0
4
Aetna Medicare Value Plus Plan (PPO) (2023)Local PPO$7,550$195
5
Humana Gold Plus H1951-048 (HMO) (2023)Local HMO$3,700$0
4
Vantage BASIC (HMO-POS) (2023)Local HMO$5,900$445
4
HumanaChoice R0110-001 (Regional PPO) (2023)Regional PPO *$7,550$-
4
Peoples Health Choices 65 (HMO) (2023)Local HMO$4,700$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Vantage TRADITIONAL PLUS (HMO-POS) (2023)Local HMO$7,550$445
4
Peoples Health Choices (PPO) (2023)Local PPO$6,700$100
New plan - not yet rated.
WellCare Value (HMO) (2023)Local HMO$3,400$0
5
Peoples Health Patriot (PPO) (2023)Local PPO *$6,700$-
New plan - not yet rated.
WellCare Compass (HMO) (2023)Local HMO$3,400$445
5
Allwell Medicare Simple (HMO) (2023)Local HMO *$5,500$-
New plan - not yet rated.
HumanaChoice H5216-064 (PPO) (2023)Local PPO$6,700$0
4
WellCare Baton Rouge Preferred (HMO) (2023)Local HMO$3,400$0
5
WellCare Endurance (HMO) (2023)Local HMO$3,400$0
5
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4

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