4

4 out of 5 stars* for plan year 2024

Plan ID: H3305-020

What You Need to Know:

  • MVP Medicare Preferred Gold without Part D (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 $62, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is no drug coverage.
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • MVP Medicare Preferred Gold without Part D (HMO-POS) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is no drug coverage.
  • This plan's Part D Initial Coverage Limit is .

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$62

Monthly Premium

Medicare Plan Features
Monthly Premium: $62.00
Part C Premium: NULL
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$62.00 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local HMO *
Similar Plan: H3305-021
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $7,550
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Grand Isle, Vermont: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members 4.5 out of 5 Stars. 4 out of 5 Stars. 4 out of 5 Stars.
Plan Offers Mail Order: NULL
Plan Health Benefits
Total # of Formulary Drugs: NULL
Number of Members Enrolled in this Plan in Grand Isle, Vermont: less than 10 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
NULL NULL NULL NULL
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
NULL NULL NULL NULL NULL NULL NULL
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)
NULL NULL NULL NULL NULL NULL NULL NULL NULL NULL

Other Medicare Advantage Plans in Grand Isle, Vermont

Plan Name Type Premium MOOP Rx Deduct. Rating
Vermont Blue Advantage Unity HMO (HMO) (2023)Local HMO$6,700$200
New plan - not yet rated.
Vermont Blue Advantage Freedom PPO (PPO) (2023)Local PPO$6,900$250
New plan - not yet rated.
Vermont Blue Advantage Freedom Plus PPO (PPO) (2023)Local PPO$5,000$150
New plan - not yet rated.
MVP Medicare Secure with Part D (HMO-POS) (2023)Local HMO$7,550$150
4
MVP Medicare WellSelect with Part D (PPO) (2023)Local PPO$7,550$325
4
MVP Medicare Secure Plus with Part D (HMO-POS) (2023)Local HMO$7,550$0
4
MVP Medicare WellSelect Plus with Part D (PPO) (2023)Local PPO$6,500$0
4
MVP Medicare Preferred Gold with Part D (HMO-POS) (2023)Local HMO$5,800$0
4
AARP Medicare Advantage Plan 1 (HMO) (2023)Local HMO$6,700$250
5
AARP Medicare Advantage Plan 2 (HMO) (2023)Local HMO$5,900$150
5
MVP SmartFund (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage Plan 3 (HMO) (2023)Local HMO$6,700$0
5
AARP Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5
UnitedHealthcare Medicare Advantage Assure (PPO) (2023)Local PPO$7,550$445
5
Medicare Advantage Plans by MVP HEALTH CARE
MVP Medicare Secure with Part D (HMO-POS) (2023)Local HMO$7,550$150
4
MVP Medicare WellSelect with Part D (PPO) (2023)Local PPO$7,550$325
4
MVP Medicare Secure Plus with Part D (HMO-POS) (2023)Local HMO$7,550$0
4
MVP Medicare WellSelect Plus with Part D (PPO) (2023)Local PPO$6,500$0
4
MVP Medicare Preferred Gold with Part D (HMO-POS) (2023)Local HMO$5,800$0
4
MVP SmartFund (MSA) (2023)MSA *$-$-
4

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