5

5 out of 5 stars* for plan year 2024

Plan ID: H3449-023

What You Need to Know:

  • Blue Medicare Essential Plus (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 $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
  • The plan includes an out-of-pocket maximum of $4,200 per year (in-network).
  • Blue Medicare Essential Plus (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $195 (Tier 1, 2 and 3 excluded from the Deductible.).
  • This plan's Part D Initial Coverage Limit is $25.

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

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
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:
$0 $0 $0 $0 $0 $195.0 1.0
Gap Coverage: Yes
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H3449-024
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): $4,200
Annual Deductible: $195 (Tier 1, 2 and 3 excluded from the Deductible.)
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Yadkin, North Carolina: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
306 members 4 out of 5 Stars. 5 out of 5 Stars. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,069 drugs
Number of Members Enrolled in this Plan in Yadkin, North Carolina: 28,563 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
$14.20 $24.80 $0.00 $39.00
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
$14.20 $18.60 $32.80 $12.40 $26.60 $6.20 $20.40
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)
142 $0.00 543 $10.00 773 $37.00 725 41% 677 29%

Other Medicare Advantage Plans in Yadkin, North Carolina

Plan Name Type Premium MOOP Rx Deduct. Rating
AARP Medicare Advantage Plan 2 (HMO-POS) (2023)Local HMO$4,500$95
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Cigna Preferred Medicare (HMO) (2023)Local HMO$4,900$0
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Cigna Fundamental Medicare (HMO) (2023)Local HMO *$4,900$-
4
AARP Medicare Advantage Patriot (HMO-POS) (2023)Local HMO *$3,600$-
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Cigna Preferred Plus Medicare (HMO) (2023)Local HMO$3,900$0
4
Blue Medicare Medical Only (HMO) (2023)Local HMO *$4,400$-
5
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
HumanaChoice R1390-002 (Regional PPO) (2023)Regional PPO$7,550$360
4
HumanaChoice R1390-001 (Regional PPO) (2023)Regional PPO *$5,400$-
4
Blue Medicare Essential (HMO) (2023)Local HMO$6,700$375
5
Aetna Medicare Prime (HMO) (2023)Local HMO$4,500$0
New plan - not yet rated.
Humana Gold Plus H1036-291 (HMO) (2023)Local HMO$3,900$0
4
HumanaChoice H5216-211 (PPO) (2023)Local PPO$6,700$160
4
Humana Honor R1390-003 (Regional PPO) (2023)Regional PPO *$6,700$-
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,900$50
5
Cigna True Choice Medicare (PPO) (2023)Local PPO$5,750$0
New plan - not yet rated.
Aetna Medicare Premier Plan (PPO) (2023)Local PPO$7,000$150
5
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage Plan 1 (HMO-POS) (2023)Local HMO$3,600$50
5
Medicare Advantage Plans by Blue Cross and Blue Shield of North Carolina
Blue Medicare Enhanced (HMO) (2023)Local HMO$3,900$0
5
Blue Medicare Medical Only (HMO) (2023)Local HMO *$4,400$-
5
Blue Medicare Essential (HMO) (2023)Local HMO$6,700$375
5

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