5

5 out of 5 stars* for plan year 2024

Plan ID: H5521-261

What You Need to Know:

  • Aetna Medicare Value (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 $0, 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 $7,550 per year (in-network).
  • Aetna Medicare Value (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 $0.

* 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 $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: H5521-262
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): $7,550
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Clearfield, Pennsylvania: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
81 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: 3,800 drugs
Number of Members Enrolled in this Plan in Clearfield, Pennsylvania: 3,567 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 $0.00 $0.00 $0.00
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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
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)
369 $0.00 575 $0.00 902 $47.00 1243 $100.00 711 33%

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3
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HumanaChoice R0923-002 (Regional PPO) (2023)Regional PPO$6,700$0
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3
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UPMC for Life PPO Rx Enhanced (PPO) (2023)Local PPO$7,550$0
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Aetna Medicare Advantra Eagle (HMO) (2023)Local HMO *$4,000$-
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Aetna Medicare PennHighlands Prime (HMO) (2023)Local HMO$7,550$0
5
Aetna Medicare Gold Plan (PPO) (2023)Local PPO$7,550$0
5
Geisinger Gold Classic Essential Rx (HMO) (2023)Local HMO$7,550$0
4
Community Blue Medicare HMO Signature (HMO) (2023)Local HMO$7,550$0
4
Aetna Medicare Advantra Gold (HMO) (2023)Local HMO$4,900$0
5
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4
Geisinger Gold Classic 360 Rx (HMO) (2023)Local HMO$7,550$0
4
Aetna Medicare Advantra Silver (HMO) (2023)Local HMO$7,550$0
5
Geisinger Gold Classic Advantage (HMO) (2023)Local HMO *$3,450$-
4
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4
Freedom Blue PPO ValueRx (PPO) (2023)Local PPO$5,500$0
4
Security Blue HMO-POS ValueRx (HMO-POS) (2023)Local HMO$5,500$0
4
Geisinger Gold Classic Advantage Rx (HMO) (2023)Local HMO$3,450$0
4
Geisinger Gold Preferred Advantage Rx (PPO) (2023)Local PPO$4,000$0
3
Geisinger Gold Classic Complete Rx (HMO) (2023)Local HMO$4,900$0
4
Freedom Blue PPO Classic (PPO) (2023)Local PPO$4,500$0
4
Security Blue HMO-POS Standard (HMO-POS) (2023)Local HMO$5,000$0
4
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$0
4
Complete Blue PPO Distinct (PPO) (2023)Local PPO$6,500$0
4
Security Blue HMO-POS Deluxe (HMO-POS) (2023)Local HMO$4,500$0
4
UPMC for Life HMO Rx (HMO) (2023)Local HMO$7,550$0
4
Geisinger Gold Preferred Complete Rx (PPO) (2023)Local PPO$6,700$0
3
UPMC for Life HMO Deductible with Rx (HMO) (2023)Local HMO$7,550$0
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Geisinger Gold Preferred Enhanced Rx (PPO) (2023)Local PPO$6,700$0
3
Allwell Medicare (HMO) (2023)Local HMO$6,700$0
4
Aetna Medicare Silver (HMO) (2023)Local HMO$7,550$0
5
UPMC for Life HMO No Rx (HMO) (2023)Local HMO *$7,550$-
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
UPMC for Life HMO Rx Choice (HMO) (2023)Local HMO$7,550$0
4
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4
Allwell Medicare Complement (HMO) (2023)Local HMO$7,550$445
4
Freedom Blue PPO Select (PPO) (2023)Local PPO$5,000$0
4
UPMC for Life HMO Rx Enhanced (HMO) (2023)Local HMO$7,550$0
4
Medicare Advantage Plans by Aetna Medicare
Aetna Medicare Advantra Silver (PPO) (2023)Local PPO$7,550$0
5
Aetna Medicare Advantra Credit Value (PPO) (2023)Local PPO$7,550$250
5
Aetna Medicare Advantra Eagle (HMO) (2023)Local HMO *$4,000$-
5
Aetna Medicare PennHighlands Prime (HMO) (2023)Local HMO$7,550$0
5
Aetna Medicare Gold Plan (PPO) (2023)Local PPO$7,550$0
5
Aetna Medicare Advantra Gold (HMO) (2023)Local HMO$4,900$0
5
Aetna Medicare Advantra Silver (HMO) (2023)Local HMO$7,550$0
5
Aetna Medicare Silver (HMO) (2023)Local HMO$7,550$0
5

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