Plan ID: H3192-001

What You Need to Know:

  • Aetna Medicare Prime (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 .
  • The plan includes an out-of-pocket maximum of $3,950 per year (in-network).
  • Aetna Medicare Prime (HMO) 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.

$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 HMO
Similar Plan: H3192-002
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): $3,950
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Kane, Illinois: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
69 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: 3,780 drugs
Number of Members Enrolled in this Plan in Kane, Illinois: 1,604 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)
337 $0.00 571 $0.00 915 $47.00 1247 $100.00 710 33%

Other Medicare Advantage Plans in Kane, Illinois

Plan Name Type Premium MOOP Rx Deduct. Rating
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4
Aetna Medicare Eagle (PPO) (2023)Local PPO *$5,900$-
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Clear Spring Health Community Advantage Plan (HMO) (2023)Local HMO$3,950$0
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Clear Spring Health Community Flex Plan (HMO-POS) (2023)Local HMO$3,950$0
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Clear Spring Health Essential (HMO) (2023)Local HMO$2,900$0
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WellCare Value (HMO-POS) (2023)Local HMO$3,450$0
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HumanaChoice H5216-251 (PPO) (2023)Local PPO$5,500$200
4
Cigna True Choice Medicare (PPO) (2023)Local PPO$4,400$0
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Blue Cross Medicare Advantage Basic (HMO) (2023)Local HMO$3,400$0
5
Blue Cross Medicare Advantage Basic Plus (HMO-POS) (2023)Local HMO$3,900$0
5
Blue Cross Medicare Advantage Premier Plus (HMO-POS) (2023)Local HMO$4,500$0
5
Blue Medicare Advocate Health (HMO) (2023)Local HMO$3,500$0
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Blue Cross Medicare Advantage Choice Plus (PPO) (2023)Local PPO$6,700$445
4
Blue Cross Medicare Advantage Choice Premier (PPO) (2023)Local PPO$5,900$0
4
AARP Medicare Advantage Walgreens (PPO) (2023)Local PPO$5,900$250
5
WellCare Compass (HMO) (2023)Local HMO$3,450$445
4
Blue Cross Medicare Advantage Classic (PPO) (2023)Local PPO$7,550$445
4
WellCare Plus (HMO) (2023)Local HMO$3,450$445
4
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$3,475$0
5
Aetna Medicare Value (PPO) (2023)Local PPO$3,950$0
5
UnitedHealthcare Medicare Advantage Assure (PPO) (2023)Local PPO$7,550$445
5
Humana Gold Choice H8145-008 (PFFS) (2023)PFFS$-$380
4
WellCare Essential (HMO) (2023)Local HMO$3,450$0
5
AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$5,900$-
5
WellCare Edge (HMO) (2023)Local HMO$3,450$445
5
Aetna Medicare DMG Prime (PPO) (2023)Local PPO$3,950$0
5
WellCare Premier (PPO) (2023)Local PPO$3,450$0
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AARP Medicare Advantage Access (HMO) (2023)Local HMO$3,600$100
5
WellCare Absolute (PPO) (2023)Local PPO$3,450$0
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AARP Medicare Advantage Plan 1 (HMO) (2023)Local HMO$3,900$195
5
Bright Advantage Choice Plus (PPO) (2023)Local PPO$6,700$0
New plan - not yet rated.
Bright Advantage Choice (PPO) (2023)Local PPO$4,000$400
New plan - not yet rated.
AARP Medicare Advantage Plan 2 (HMO) (2023)Local HMO$3,900$60
5
Bright Advantage Assist (HMO) (2023)Local HMO$6,700$445
New plan - not yet rated.
Bright Advantage (HMO) (2023)Local HMO$3,400$0
New plan - not yet rated.
HumanaChoice R5361-001 (Regional PPO) (2023)Regional PPO *$6,700$-
5
Humana Gold Plus H1468-014 (HMO) (2023)Local HMO$6,700$0
4
Humana Community Select HMO H1468-018 (HMO) (2023)Local HMO$2,650$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
HumanaChoice H5216-013 (PPO) (2023)Local PPO$3,750$0
4
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.
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,900$195
5
Cigna Premier Medicare (HMO-POS) (2023)Local HMO$4,500$0
5
Cigna Preferred Medicare (HMO) (2023)Local HMO$3,450$0
5
Ascension Complete AMITA Health Reward (HMO) (2023)Local HMO$7,550$430
New plan - not yet rated.
Ascension Complete AMITA Health Secure (HMO) (2023)Local HMO$2,900$0
New plan - not yet rated.
Cigna Fundamental Medicare (HMO) (2023)Local HMO *$6,700$-
5
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
WellCare Patriot (HMO-POS) (2023)Local HMO *$3,450$-
4
Medicare Advantage Plans by Aetna Medicare
Aetna Medicare Eagle (PPO) (2023)Local PPO *$5,900$-
5
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$3,475$0
5
Aetna Medicare Value (PPO) (2023)Local PPO$3,950$0
5
Aetna Medicare DMG Prime (PPO) (2023)Local PPO$3,950$0
5

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