3

3 out of 5 stars* for plan year 2024

Plan ID: H1660-018

What You Need to Know:

  • Harvard Pilgrim Stride Choice Rx (HMO-POS) 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 $34, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is $300 (Tier 1 and 2 excluded from the Deductible.).
  • The plan includes an out-of-pocket maximum of $5,600 per year (in-network).
  • Harvard Pilgrim Stride Choice Rx (HMO-POS) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $300 (Tier 1 and 2 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.

$34

Monthly Premium

Medicare Plan Features
Monthly Premium: $34.00
Part C Premium: $9.00
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$34.00 $9.00 $25.00 $0 $25.00 $300.0 1.0
Gap Coverage: Yes
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H1660-013
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): $5,600
Annual Deductible: $300 (Tier 1 and 2 excluded from the Deductible.)
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in York, Maine: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
101 members 4 out of 5 Stars. 3 out of 5 Stars. 5 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,708 drugs
Number of Members Enrolled in this Plan in York, Maine: 323 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
$9.00 $25.00 $0.00 $34.00
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
$9.00 $18.70 $27.70 $12.50 $21.50 $6.20 $15.20
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)
356 $0.00 2051 $10.00 216 $47.00 307 $100.00 778 27%

Other Medicare Advantage Plans in York, Maine

Plan Name Type Premium MOOP Rx Deduct. Rating
HumanaChoice H5216-177 (PPO) (2023)Local PPO$5,500$0
4
Aetna Medicare Explorer Plan (PPO) (2023)Local PPO$7,550$250
5
Martin's Point Generations Advantage Select (PPO) (2023)Local PPO$7,300$0
5
Martin's Point Generations Advantage Alliance (HMO) (2023)Local HMO *$5,000$-
5
Martin's Point Generations Advantage Prime (HMO-POS) (2023)Local HMO$7,050$0
5
Harvard Pilgrim Stride Value Rx (HMO) (2023)Local HMO$6,700$300
3
Harvard Pilgrim Stride Basic Rx (HMO) (2023)Local HMO$6,700$445
3
Martin's Point Generations Advantage Value Plus (HMO) (2023)Local HMO$7,550$275
5
AARP Medicare Advantage Choice Plan 1 (PPO) (2023)Local PPO$5,900$250
5
Humana Gold Plus H5619-001 (HMO) (2023)Local HMO$6,700$400
4
AARP Medicare Advantage Choice Plan 2 (PPO) (2023)Local PPO$5,500$150
5
Humana Gold Plus H5619-066 (HMO) (2023)Local HMO$7,550$355
4
Anthem l MaineHealth Advantage Choice (HMO-POS) (2023)Local HMO$5,500$0
New plan - not yet rated.
AARP Medicare Advantage Choice Plan 3 (PPO) (2023)Local PPO$6,700$0
5
WellCare Today's Options Advantage Plus 550B (PPO) (2023)Local PPO$4,000$0
5
Anthem l MaineHealth Advantage Extra (HMO) (2023)Local HMO$4,900$275
New plan - not yet rated.
Anthem l MaineHealth Advantage Access (PPO) (2023)Local PPO$5,800$400
New plan - not yet rated.
Aetna Medicare Value Plan (HMO) (2023)Local HMO$5,900$0
5
WellCare Value (HMO) (2023)Local HMO$6,700$0
4
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4
Martin's Point Generations Advantage Flex (Regional PPO) (2023)Regional PPO$5,500$275
5
HumanaChoice H5216-175 (PPO) (2023)Local PPO$6,500$250
4
AARP Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$7,550$295
5
Medicare Advantage Plans by Harvard Pilgrim Health Care, Inc
Harvard Pilgrim Stride Value Rx (HMO) (2023)Local HMO$6,700$300
3
Harvard Pilgrim Stride Basic Rx (HMO) (2023)Local HMO$6,700$445
3

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