4

4 out of 5 stars* for plan year 2024

Plan ID: H1608-054

What You Need to Know:

  • Aetna Medicare Elite (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO 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 $6,000 per year (in-network).
  • Aetna Medicare Elite (PPO) 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.

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

$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 PPO
Similar Plan: H1608-055
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): $6,000
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Boone, Arkansas: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
48 members 3.5 out of 5 Stars. 4 out of 5 Stars. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,771 drugs
Number of Members Enrolled in this Plan in Boone, Arkansas: 2,626 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)
333 $0.00 568 $5.00 915 $47.00 1240 $100.00 715 33%

Other Medicare Advantage Plans in Boone, Arkansas

Plan Name Type Premium MOOP Rx Deduct. Rating
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
HumanaChoice H5216-083 (PPO) (2023)Local PPO$6,700$195
4
HumanaChoice H5216-139 (PPO) (2023)Local PPO$6,700$0
4
AARP Medicare Advantage Plan 1 (HMO) (2023)Local HMO$5,900$250
5
AARP Medicare Advantage Plan 2 (HMO) (2023)Local HMO$4,500$0
5
Humana Honor (PPO) (2023)Local PPO *$4,500$-
4
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$7,550$0
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$4,500$-
5
BlueMedicare Value Choice (PPO) (2023)Local PPO$6,700$250
New plan - not yet rated.
BlueMedicare Premier Choice (PPO) (2023)Local PPO$7,500$195
New plan - not yet rated.
BlueMedicare Value (PFFS) (2023)PFFS *$-$-
5
BlueMedicare Preferred (PFFS) (2023)PFFS$-$420
5
HumanaChoice H5216-163 (PPO) (2023)Local PPO$7,550$195
4
HumanaChoice H5216-231 (PPO) (2023)Local PPO$4,200$0
4
Humana Value Plus H5619-109 (HMO) (2023)Local HMO$7,550$445
4
Humana Gold Plus H5619-111 (HMO) (2023)Local HMO$5,400$0
4
Allwell Medicare (HMO) (2023)Local HMO$7,300$250
3
Allwell Medicare Premier (HMO) (2023)Local HMO$7,100$250
3
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$5,900$250
5
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$445
3
Allwell Medicare Simple (HMO) (2023)Local HMO *$4,900$-
3
HumanaChoice R1532-001 (Regional PPO) (2023)Regional PPO *$3,900$-
4
HumanaChoice R1532-002 (Regional PPO) (2023)Regional PPO$6,700$400
4
UnitedHealthcare Medicare Advantage Choice Plan 2 (Region (2023)Regional PPO$6,700$295
5
UnitedHealthcare Medicare Advantage Choice Plan 3 (Region (2023)Regional PPO$6,700$245
5
Medicare Advantage Plans by Aetna Medicare
Aetna Medicare Premier Plus (PPO) (2023)Local PPO$7,550$0
4

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