Plan ID: H1664-001

What You Need to Know:

  • Allwell Medicare (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 $3,400 per year (in-network).
  • Allwell Medicare (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: H1664-002
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): $3,400
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Taney, Missouri: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
27 members New plan - No summary rating as of yet. New plan - not yet rated. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,411 drugs
Number of Members Enrolled in this Plan in Taney, Missouri: 991 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)
217 $0.00 410 $5.00 1011 $37.00 902 $90.00 680 33%

Other Medicare Advantage Plans in Taney, Missouri

Plan Name Type Premium MOOP Rx Deduct. Rating
Anthem MediBlue Access (PPO) (2023)Local PPO$5,000$0
5
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$4,900$95
5
Healthy Blue Essential (HMO) (2023)Local HMO$3,400$0
New plan - not yet rated.
Aetna Medicare Premier (HMO) (2023)Local HMO$3,450$0
4
Aetna Medicare Premier Plus (HMO-POS) (2023)Local HMO$4,400$0
4
Aetna Medicare Premier Preferred (HMO) (2023)Local HMO$3,450$0
4
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$5,700$0
4
Aetna Medicare Elite (PPO) (2023)Local PPO$5,000$0
4
UnitedHealthcare Medicare Advantage Choice Plan 2 (Region (2023)Regional PPO$6,700$295
5
HumanaChoice H5216-033 (PPO) (2023)Local PPO$5,900$0
4
CoxHealth MedicarePlus (HMO) (2023)Local HMO$3,200$0
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$3,900$0
5
UnitedHealthcare Medicare Advantage Choice Plan 3 (Region (2023)Regional PPO$6,700$245
5
Allwell Medicare Complement (HMO) (2023)Local HMO$3,400$445
New plan - not yet rated.
Anthem MediBlue Plus (HMO) (2023)Local HMO$3,400$0
4
Humana Gold Choice H8145-125 (PFFS) (2023)PFFS$-$195
4
AARP Medicare Advantage Plan 2 (HMO-POS) (2023)Local HMO$3,700$100
5
AARP Medicare Advantage Plan 1 (HMO-POS) (2023)Local HMO$3,400$0
5
HumanaChoice R1532-001 (Regional PPO) (2023)Regional PPO *$3,900$-
4
HumanaChoice R1532-002 (Regional PPO) (2023)Regional PPO$6,700$400
4
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$445
New plan - not yet rated.
AARP Medicare Advantage Patriot (HMO-POS) (2023)Local HMO *$3,700$-
5
Humana Gold Plus H0028-016 (HMO) (2023)Local HMO$7,550$195
4
Humana Gold Plus H4623-001 (HMO) (2023)Local HMO$3,450$0
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
WellCare Premier (PPO) (2023)Local PPO$5,900$0
New plan - not yet rated.
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4
HumanaChoice H5216-032 (PPO) (2023)Local PPO$6,700$195
4
WellCare Patriot (PPO) (2023)Local PPO *$4,000$-
New plan - not yet rated.
Humana Gold Choice H8145-120 (PFFS) (2023)PFFS *$-$-
4
Aetna Medicare Eagle (HMO) (2023)Local HMO *$3,450$-
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Medicare Advantage Plans by Allwell
Allwell Medicare Complement (HMO) (2023)Local HMO$3,400$445
New plan - not yet rated.
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$445
New plan - not yet rated.

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