5

5 out of 5 stars* for plan year 2024

Plan ID: H5422-014

What You Need to Know:

  • Anthem MediBlue Core (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 no drug coverage.
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • Anthem MediBlue Core (HMO) 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.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
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:
$0 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local HMO *
Similar Plan: H5422-008
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 Coweta, Georgia: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members 3.5 out of 5 Stars. 5 out of 5 Stars. 3 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 Coweta, Georgia: 9 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 Coweta, Georgia

Plan Name Type Premium MOOP Rx Deduct. Rating
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
AARP Medicare Advantage Plus Plan 1 (HMO-POS) (2023)Local HMO$6,700$275
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UnitedHealthcare Medicare Advantage Patriot (Regional PPO (2023)Regional PPO *$6,700$-
5
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$6,700$150
4
AARP Medicare Advantage Plus Plan 2 (HMO-POS) (2023)Local HMO$4,900$175
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Cigna True Choice Medicare (PPO) (2023)Local PPO$6,950$95
New plan - not yet rated.
HumanaChoice H5216-241 (PPO) (2023)Local PPO$7,550$445
4
HumanaChoice R3392-001 (Regional PPO) (2023)Regional PPO *$6,700$-
4
Aetna Medicare Essential Plan (PPO) (2023)Local PPO$6,900$195
5
HumanaChoice R3392-002 (Regional PPO) (2023)Regional PPO$6,700$340
4
Aetna Medicare Value Plus Plan (PPO) (2023)Local PPO$7,550$195
5
UnitedHealthcare Medicare Advantage Choice (Regional PPO) (2023)Regional PPO$6,700$295
5
Anthem MediBlue Plus (HMO) (2023)Local HMO$6,700$150
5
Anthem MediBlue Extra (HMO) (2023)Local HMO$5,900$445
5
UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO) (2023)Local PPO$6,700$275
5
Anthem MediBlue Access (PPO) (2023)Local PPO$5,900$95
4
HumanaChoice H5216-203 (PPO) (2023)Local PPO$7,550$0
4
Cigna Preferred Medicare (HMO) (2023)Local HMO$6,200$0
4
WellCare Flex Complete (PPO) (2023)Local PPO$2,500$0
5
WellCare Dividend (HMO) (2023)Local HMO$6,700$200
5
Kaiser Permanente Senior Advantage Basic (HMO) (2023)Local HMO$6,400$0
5
Aetna Medicare Advantra Preferred Plan (PPO) (2023)Local PPO$7,550$200
4
Aetna Medicare Plus Plan (PPO) (2023)Local PPO$7,550$400
New plan - not yet rated.
Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$6,900$-
New plan - not yet rated.
HumanaChoice H5216-154 (PPO) (2023)Local PPO$7,550$400
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
WellCare Patriot (HMO-POS) (2023)Local HMO *$3,400$-
5
HumanaChoice H5216-073 (PPO) (2023)Local PPO$6,700$360
4
WellCare Premier (PPO) (2023)Local PPO$4,900$75
5
WellCare Endurance (PPO) (2023)Local PPO$4,900$0
5
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Humana Gold Plus H4141-017 (HMO) (2023)Local HMO$7,550$0
4
HumanaChoice H5216-157 (PPO) (2023)Local PPO *$6,700$-
4
WellCare Value (HMO) (2023)Local HMO$3,450$0
5
WellCare Compass (HMO) (2023)Local HMO$3,450$445
5
Cigna Preferred GA Medicare (HMO) (2023)Local HMO$7,500$300
4
WellCare Prime (PPO) (2023)Local PPO$5,100$0
5
Kaiser Permanente Senior Advantage Enhanced (HMO) (2023)Local HMO$4,500$0
5
Medicare Advantage Plans by Anthem Blue Cross and Blue Shield
Anthem MediBlue Access Basic (PPO) (2023)Local PPO$6,700$150
4
Anthem MediBlue Plus (HMO) (2023)Local HMO$6,700$150
5
Anthem MediBlue Extra (HMO) (2023)Local HMO$5,900$445
5
Anthem MediBlue Access (PPO) (2023)Local PPO$5,900$95
4

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