Clever Care Balance Medicare Advantage (HMO) in San Diego, California (2023)
Clever Care Balance Medicare Advantage (HMO) in San Diego County, California costs $31/mo. This affordable Regional PPO plan (H7607-003) is a top choice for those living in San Diego County with a $435 prescription deductible and out-of-pocket limits at $7,550. Learn more about Medicare Part C by AARP in San Diego County, California below.
Read moreUPDATED: Sep 19, 2023
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UPDATED: Sep 19, 2023Fact Checked
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Plan ID: H7607-003
What You Need to Know:
- Clever Care Balance Medicare Advantage (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 $32, which does not include your monthly Medicare Part B premium.
- The annual deductible for this health plan is $435 (Tier 1 excluded from the Deductible.).
- The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
- Clever Care Balance Medicare Advantage (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $435 (Tier 1 excluded from the Deductible.).
- This plan's Part D Initial Coverage Limit is $32.
$32
Monthly Premium
| Medicare Plan Features | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Monthly Premium: | $31.50 | ||||||||
| 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: | |||
| $31.50 | $0 | $31.50 | $0 | $31.50 | $435.0 | 1.0 | |||
| Gap Coverage: | Yes | ||||||||
| Benchmark: | not below the regional benchmark | ||||||||
| Type of Medicare Health: | Enhanced Alternative | ||||||||
| Health Plan Type: | Local HMO | ||||||||
| Similar Plan: | H7607-002 | ||||||||
| 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): | $7,550 | ||||||||
| Annual Deductible: | $435 (Tier 1 excluded from the Deductible.) | ||||||||
| Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
| Number of Members enrolled in this plan in San Diego, California: | Plans Summary Star Rating: | Customer Service Rating: | Drug Cost Rating: | ||||||
| less than 10 members | New plan - No summary rating as of yet. | New plan - not yet rated. | New plan - not yet rated. | ||||||
| Plan Offers Mail Order: | Yes | ||||||||
| Plan Health Benefits | |||||||||
| Total # of Formulary Drugs: | 3,619 drugs | ||||||||
| Number of Members Enrolled in this Plan in San Diego, California: | 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 | ||||||
| $0.00 | $31.50 | $0.00 | $31.50 | ||||||
| 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 | $23.60 | $23.60 | $15.80 | $15.80 | $7.90 | $7.90 | |||
| 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) |
| 354 | 0% | 1915 | 25% | 346 | 25% | 174 | 25% | 830 | 25% |
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