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2014 Medicare Advantage Plans in Orange County Florida QOOQe
2014 Medicare Advantage Plans in Orange County Florida

2014 Medicare Advantage Plans in Orange County Florida

There are 32 Medicare Advantage Plans available in Orange County FL from 14 health insurance providers and 28 Special Needs Plans available. 12 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700. The highest rated plan available in Orange County received a 4.5 overall star rating from CMS and the lowerst rated plan is 3 stars.

(Click the Plan Name for More Details)
Plan Name Type Premium C+D Part D
Deductible
Gap Max Out of Pocket Overall Rating
Return to Counties In Florida
AARP MedicareComplete (HMO)
(H1080-043)
Local HMO $0 $0 No Gap Coverage $5,900
AARP MedicareComplete Choice Essential (Regional PPO)
(R5287-002)
Regional PPO * $0 $6,700
AARP MedicareComplete Choice Plan 2 (Regional PPO)
(R5287-001)
Regional PPO $0 $0 No Gap Coverage $6,700
Amerivantage Classic+ Rx Plan (HMO)
(H8991-028)
Local HMO $0 $0 No Gap Coverage $6,700
BlueMedicare HMO LifeTime (HMO)
(H1026-040)
Local HMO $0 $0 Many Generics $4,900
BlueMedicare HMO PrimeTime (HMO)
(H1026-054)
Local HMO $0 $0 No Gap Coverage $3,400
BlueMedicare Regional PPO (Regional PPO)
(R3332-001)
Regional PPO $0 $30.00 No Gap Coverage $6,700
CareOne PLUS (HMO)
(H1019-057)
Local HMO $0 $0 Some Generics, Few Brands $3,400
Day Break (HMO)
(H4199-008)
Local HMO $0 $0 All Generics $3,400 NA
Day Light (HMO)
(H4199-009)
Local HMO * $0 $3,400 NA
Freedom Medicare Plan Rx (HMO)
(H5427-060)
Local HMO $0 $0 Many Generics $3,400
Freedom Savings Plan (HMO)
(H5427-052)
Local HMO * $0 $3,400
Freedom Savings Plan Rx (HMO)
(H5427-054)
Local HMO $0 $0 No Gap Coverage $3,400
Humana Gold Choice H8145-061 (PFFS)
(H8145-061)
PFFS $103.00 $0 Few Generics, Few Brands N/A
Humana Gold Plus H1036-146 (HMO)
(H1036-146)
Local HMO $0 $0 Some Generics, Few Brands $3,400
HumanaChoice R5826-005 (Regional PPO)
(R5826-005)
Regional PPO $92.00 $0 Few Generics, Few Brands $5,700
HumanaChoice R5826-018 (Regional PPO)
(R5826-018)
Regional PPO * $0 $4,000
HumanaChoice R5826-074 (Regional PPO)
(R5826-074)
Regional PPO $0 $150.00 Few Generics, Few Brands $5,900
Optimum Gold Rewards Plan (HMO-POS)
(H5594-022)
Local HMO $0 $0 No Gap Coverage $6,700
Optimum Platinum Plan (HMO-POS)
(H5594-033)
Local HMO $0 $0 Many Generics $3,400
Preferred Secure Option (HMO)
(H1045-023)
Local HMO $0 $0 No Gap Coverage $6,700
PUP PLUS (HMO)
(H5696-034)
Local HMO $0 $0 No Gap Coverage $6,700
PUP REWARDS (HMO)
(H5696-004)
Local HMO $0 $0 No Gap Coverage $4,300
PUP SIMPLE (HMO)
(H5696-033)
Local HMO $0 $0 Many Generics $4,200
Simply Extra (HMO)
(H5471-044)
Local HMO $0 $0 No Gap Coverage $5,500
Simply More (HMO)
(H5471-043)
Local HMO $0 $0 Many Generics $3,400
Sunrise (HMO)
(H4199-007)
Local HMO $0 $0 All Generics $3,400 NA
WellCare Advance (HMO)
(H1032-037)
Local HMO * $0 $6,700
WellCare Choice (HMO-POS)
(H1032-002)
Local HMO $46.00 $0 No Gap Coverage $6,700
WellCare Dividend (HMO)
(H1032-179)
Local HMO $0 $0 No Gap Coverage $6,700
WellCare Essential (HMO)
(H1032-173)
Local HMO $0 $0 No Gap Coverage $6,700
WellCare Value (HMO-POS)
(H1032-091)
Local HMO $0 $0 No Gap Coverage $6,700

* Plan Type Indicates plan does not offer Part D drug coverage.



Medicare Special Needs Plans in Orange county Florida

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Advantage by Sunshine Health (HMO SNP)
(H5190- 001)
Local HMO $21.00 $310.00 No Gap Coverage Dual-EligibleToo New
Amerivantage Specialty + Rx (HMO SNP)
(H8991- 017)
Local HMO $22.10 $310.00 Some Generics Dual-Eligible
CareDirect (HMO SNP)
(H1019- 066)
Local HMO $0 $0 Some Generics, Few Brands Chronic or Disabling Condition
CareNeeds (HMO SNP)
(H1019- 028)
Local HMO $16.30 $310.00 No Gap Coverage Dual-Eligible
CareNeeds PLUS (HMO SNP)
(H1019- 049)
Local HMO $12.20 $310.00 No Gap Coverage Dual-Eligible
Clear Skies (HMO SNP)
(H4199- 010)
Local HMO $0 $0 All Generics Chronic or Disabling ConditionNA
Freedom Medi-Medi Full (HMO SNP)
(H5427- 087)
Local HMO $22.10 $310.00 No Gap Coverage Dual-Eligible
Freedom Medi-Medi Partial (HMO SNP)
(H5427- 078)
Local HMO $22.10 $310.00 No Gap Coverage Dual-Eligible
Freedom VIP Care (HMO SNP)
(H5427- 070)
Local HMO $0 $0 Many Generics Chronic or Disabling Condition
Freedom VIP Care COPD (HMO SNP)
(H5427- 076)
Local HMO $0 $0 Many Generics Chronic or Disabling Condition
Freedom VIP Savings (HMO SNP)
(H5427- 072)
Local HMO $0 $0 No Gap Coverage Chronic or Disabling Condition
Freedom VIP Savings COPD (HMO SNP)
(H5427- 077)
Local HMO $0 $0 No Gap Coverage Chronic or Disabling Condition
Humana Gold Plus SNP-DB H1036-193 (HMO SNP)
(H1036- 193)
Local HMO $0 $0 Some Generics, Few Brands Chronic or Disabling Condition
Humana Gold Plus SNP-DE H1036-159 (HMO SNP)
(H1036- 159)
Local HMO $19.80 $310.00 No Gap Coverage Dual-Eligible
Humana Gold Plus SNP-DE H1036-213 (HMO SNP)
(H1036- 213)
Local HMO $15.40 $310.00 No Gap Coverage Dual-Eligible
Optimum Diamond Rewards (HMO-POS SNP)
(H5594- 030)
Local HMO $0 $0 Many Generics Chronic or Disabling Condition
Optimum Diamond Rewards COPD (HMO-POS SNP)
(H5594- 031)
Local HMO $0 $0 Many Generics Chronic or Disabling Condition
Optimum Emerald Full (HMO SNP)
(H5594- 017)
Local HMO $22.10 $310.00 No Gap Coverage Dual-Eligible
Optimum Emerald Partial (HMO SNP)
(H5594- 016)
Local HMO $22.10 $310.00 No Gap Coverage Dual-Eligible
PUP EXTRA (HMO SNP)
(H5696- 021)
Local HMO $9.90 $0 No Gap Coverage Dual-Eligible
Simply Complete (HMO SNP)
(H5471- 039)
Local HMO $22.10 $310.00 Many Generics Dual-Eligible
Simply Level (HMO SNP)
(H5471- 042)
Local HMO $0 $0 Many Generics, Few Brands Chronic or Disabling Condition
Sunny Days (HMO SNP)
(H4199- 011)
Local HMO $3.60 $0 All Generics Dual-EligibleNA
UnitedHealthcare Dual Complete RP (Regional PPO SNP)
(R5287- 003)
Regional PPO $21.80 $310.00 No Gap Coverage Dual-Eligible
UnitedHealthcare Nursing Home Plan (PPO SNP)
(H5417- 001)
Local PPO $19.80 $310.00 No Gap Coverage Institutional
WellCare Access (HMO SNP)
(H1032- 175)
Local HMO $10.40 $310.00 No Gap Coverage Dual-Eligible
WellCare Liberty (HMO SNP)
(H1032- 124)
Local HMO $9.40 $310.00 No Gap Coverage Dual-Eligible
WellCare Select (HMO SNP)
(H1032- 061)
Local HMO $11.60 $310.00 No Gap Coverage Dual-Eligible


Source: CMS.

Plans as of September 3, 2013.

Plans are subject to change as contracts are finalized.

Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.



Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescrition Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your plan for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type

Enhanced Alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.

GAP

Coverage gap ("donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. (Unless you get the low-income subsidy) Once you reach the coverage gap in 2014, you will pay 47.5% of the plan's cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail.

Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows:

  • All: 100% of formulary drugs are covered through the gap
  • Many: 65% to 100% of formulary drugs are covered through the gap
  • Some: 10% to 65 % of formulary drugs are covered through the gap
  • Few: 0% to 10% of formulary drugs are covered through the gap (and must also be >15 "brand" products covered through the gap)
  • No Gap Coverage: 0% of formulary drugs are covered through the gap (or 15 "brand" products covered through the gap)
  • All Formulary Drugs: cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit)

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

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