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Texas Medicare Advantage Plans with Prescription Drug Coverage in MONTGOMERY County

Plan Name Contract ID/Plan ID Star Rating Monthly Premium Deductible Gap Coverage? CoPay/Coinsurance Amts for 30-day Supply Details
Care Improvement Plus Medicare Advantage (PPO) H0084 / 001 2.5 out of 5 stars $0.00 $0 No Generic-$6.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Care Improvement Plus Gold Rx (PPO SNP) H0084 / 004 2.5 out of 5 stars $0.00 $0 No Generic-$6.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Care Improvement Plus Copper RX (PPO SNP) H0084 / 027 2.5 out of 5 stars $0.00 $0 No Generic-$6.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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KelseyCare Advantage Rx (HMO) H0332 / 002 4.5 out of 5 stars $0.00 $50.00 Yes Preferred Generic-$5.00
Non-Preferred Generic-$30.00
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-31%
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WellCare Value (HMO-POS) H1264 / 004 2.5 out of 5 stars $0.00 $0 Yes Generic-$3.00
Preferred Brand-$30.00
Non-Preferred Brand-$60.00
Specialty Tier-33%
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WellCare Dividend (HMO) H1264 / 008 2.5 out of 5 stars $0.00 $0 Yes Generic-$3.00
Preferred Brand-$30.00
Non-Preferred Brand-$60.00
Specialty Tier-33%
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TexanPlus Classic (HMO) H4506 / 003 3.5 out of 5 stars $0.00 $0 Yes Preferred Generic-$0
Non-Preferred Generic-$0
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-33%
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TexanPlus Select (HMO) H4506 / 027 3.5 out of 5 stars $0.00 $0 Yes Preferred Generic-$0
Non-Preferred Generic-$0
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-33%
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Humana Gold Plus H4510-028 (HMO) H4510 / 028 3.5 out of 5 stars $0.00 $0 Yes Preferred Generic-$5.00
Non-Preferred Generic-$15.00
Preferred Brand-$40.00
Non-Preferred Brand-$85.00
Specialty Tier-33%
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HealthSpring Preferred (HMO) H4513 / 001 3.5 out of 5 stars $0.00 $0 Yes Preferred Generic-$0
Non-Preferred Generic-$4.00
Preferred Brand-$30.00
Non-Preferred Brand-$60.00
Specialty Tier-33%
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AARP MedicareComplete Plus (HMO-POS) H4514 / 007 3 out of 5 stars $0.00 $0 No Preferred Generic-$3.00
Non-Preferred Generic-$6.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Aetna Medicare Premier Plan (HMO) H4523 / 015 3.5 out of 5 stars $0.00 $0 Yes Preferred Generic-$7.00
Non-Preferred Generic-$33.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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HealthSpring Achieve (HMO SNP) H4528 / 014 2.5 out of 5 stars $0.00 $0 No Preferred Generic-$3.00
Non-Preferred Generic-$8.00
Preferred Brand-$35.00
Non-Preferred Brand-$70.00
Specialty Tier-33%
Select Diabetic Drugs-$5.00
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Amerivantage Classic+ Rx (HMO) H5817 / 010 3 out of 5 stars $0.00 $0 Yes Preferred Generic-$0
Non-Preferred Generic-$4.00
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-33%
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Universal Member First (HMO) H6642 / 001 2 out of 5 stars $0.00 $0 No Preferred Generic-$0
Non-Preferred Generic-$0
Preferred Brand-$15.00
Non-Preferred Brand-$60.00
Specialty Tier-33%
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Universal Healthy Living (HMO SNP) H6642 / 007 2 out of 5 stars $0.00 $0 Yes Preferred Generic-$0
Non-Preferred Generic-$5.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Advantra (PPO) H7306 / 001 3 out of 5 stars $0.00 $0 No Preferred Generic-$3.00
Preferred Brand-$35.00
Non-Preferred Brand-$70.00
Specialty Tier-33%
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Care Improvement Plus Gold Rx (Regional PPO SNP) R6801 / 009 3 out of 5 stars $0.00 $0 No Generic-$8.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Care Improvement Plus Medicare Advantage (Regional PPO) R6801 / 012 3 out of 5 stars $0.00 $0 No Generic-$8.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Care Improvement Plus Copper RX (Regional PPO SNP) R6801 / 022 3 out of 5 stars $0.00 $0 No Generic-$8.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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WellCare Access (HMO SNP) H1264 / 007 2.5 out of 5 stars $18.00 $325.00 No Preferred Generic-$0
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-25%
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UnitedHealthcare Dual Complete (HMO SNP) H4514 / 001 3 out of 5 stars $29.40 $325.00 No Tier 1-15%
Tier 2-15%
Tier 3-15%
Tier 4-15%
Tier 5-15%
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Care Improvement Plus Silver Rx (Regional PPO SNP) R6801 / 008 3 out of 5 stars $31.80 $325.00 No Tier 1-25%
Tier 2-25%
Tier 3-25%
Tier 4-25%
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Care Improvement Plus Chrome RX (Regional PPO SNP) R6801 / 021 3 out of 5 stars $31.80 $325.00 No Tier 1-25%
Tier 2-25%
Tier 3-25%
Tier 4-25%
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Care Improvement Plus Dual Advantage (Regional PPO SNP) R6801 / 011 3 out of 5 stars $31.80 $325.00 No Tier 1-NA
Tier 2-NA
Tier 3-NA
Tier 4-NA
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Amerivantage Specialty + Rx (HMO SNP) H5817 / 009 3 out of 5 stars $31.80 $325.00 Yes Preferred Generic-$0
Non-Preferred Generic-$0
Preferred Brand-25%
Non-Preferred Brand-25%
Specialty Tier-25%
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Universal Trust (HMO SNP) H6642 / 008 2 out of 5 stars $31.80 $325.00 No Tier 1-15%
Tier 2-15%
Tier 3-15%
Tier 4-15%
Tier 5-15%
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HealthSpring TotalCare (HMO SNP) H4513 / 010 3.5 out of 5 stars $31.80 $325.00 No Tier 1-15%
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Care Improvement Plus Dual Advantage (PPO SNP) H0084 / 005 2.5 out of 5 stars $31.80 $325.00 No Tier 1-NA
Tier 2-NA
Tier 3-NA
Tier 4-NA
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Care Improvement Plus Chrome RX (PPO SNP) H0084 / 026 2.5 out of 5 stars $31.80 $325.00 No Tier 1-25%
Tier 2-25%
Tier 3-25%
Tier 4-25%
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Care Improvement Plus Silver Rx (PPO SNP) H0084 / 003 2.5 out of 5 stars $31.80 $325.00 No Tier 1-25%
Tier 2-25%
Tier 3-25%
Tier 4-25%
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Today's Options Advantage Plus 650B (PPO) H5378 / 016 2.5 out of 5 stars $32.00 $0 No Preferred Generic-$5.00
Non-Preferred Generic-$12.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-29%
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Universal Any, Any, Any (PFFS) H8098 / 001 2 out of 5 stars $34.00 $0 No Preferred Generic-$6.00
Non-Preferred Generic-$15.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Aetna Medicare Value Plan (PPO) H4524 / 013 3.5 out of 5 stars $56.00 $0 No Preferred Generic-$7.00
Non-Preferred Generic-$33.00
Preferred Brand-$45.00
Non-Preferred Brand-$95.00
Specialty Tier-33%
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Humana Prime Choice H4520-006 (PPO) H4520 / 006 3 out of 5 stars $57.00 $0 Yes Preferred Generic-$7.00
Non-Preferred Generic-$12.00
Preferred Brand-$42.00
Non-Preferred Brand-$83.00
Specialty Tier-33%
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HumanaChoice R5826-012 (Regional PPO) R5826 / 012 3.5 out of 5 stars $59.00 $125.00 No Preferred Generic-$7.00
Non-Preferred Generic-$12.00
Preferred Brand-$45.00
Non-Preferred Brand-$89.00
Specialty Tier-30%
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Blue Medicare Advantage (PPO) H1666 / 003 Plan too new to be measured $69.90 $325.00 No Preferred Generic-$3.00
Non-Preferred Generic-$10.00
Preferred Brand-$43.00
Non-Preferred Brand-$95.00
Specialty Tier-25%
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KelseyCare Advantage Rx + Choice (HMO-POS) H0332 / 004 4.5 out of 5 stars $77.00 $50.00 Yes Preferred Generic-$5.00
Non-Preferred Generic-$30.00
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-31%
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Humana Gold Choice H8145-084 (PFFS) H8145 / 084 3.5 out of 5 stars $87.00 $0 Yes Preferred Generic-$6.00
Non-Preferred Generic-$12.00
Preferred Brand-$39.00
Non-Preferred Brand-$80.00
Specialty Tier-33%
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Today's Options Advantage Plus 350A (PPO) H5378 / 010 2.5 out of 5 stars $107.00 $0 No Preferred Generic-$2.00
Non-Preferred Generic-$7.00
Preferred Brand-$40.00
Non-Preferred Brand-$80.00
Specialty Tier-33%
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KelseyCare Advantage Rx Premier (HMO) H0332 / 006 4.5 out of 5 stars $213.00 $50.00 Yes Preferred Generic-$0
Non-Preferred Generic-$20.00
Preferred Brand-$20.00
Non-Preferred Brand-$50.00
Specialty Tier-30%
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