Plan ID: H5117-006

What You Need to Know:

  • Allwell Medicare Simple (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 $5,500 per year (in-network).
  • Allwell Medicare Simple (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 .

$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: H5117-003
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $5,500
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Pointe Coupee, Louisiana: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members New plan - No summary rating as of yet. New plan - not yet rated. 2 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 Pointe Coupee, Louisiana: 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 Pointe Coupee, Louisiana

Plan Name Type Premium MOOP Rx Deduct. Rating
Vantage STANDARD (HMO-POS) (2023)Local HMO$4,900$275
4
HumanaChoice H5216-202 (PPO) (2023)Local PPO$6,700$400
4
Blue Advantage (HMO) (2023)Local HMO$4,900$0
5
WellCare Premier (PPO) (2023)Local PPO$5,000$75
New plan - not yet rated.
Wellcare Absolute (PPO) (2023)Local PPO$7,550$195
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Vantage PREMIUM (HMO-POS) (2023)Local HMO$3,500$0
4
Allwell Medicare (HMO) (2023)Local HMO$7,550$0
New plan - not yet rated.
HumanaChoice R0110-003 (Regional PPO) (2023)Regional PPO$7,550$400
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Humana Gold Plus H1951-048 (HMO) (2023)Local HMO$3,700$0
4
Vantage BASIC (HMO-POS) (2023)Local HMO$5,900$445
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
HumanaChoice R0110-001 (Regional PPO) (2023)Regional PPO *$7,550$-
4
Vantage TRADITIONAL PLUS (HMO-POS) (2023)Local HMO$7,550$445
4
Peoples Health Choices 65 (HMO) (2023)Local HMO$4,700$0
4
WellCare Value (HMO) (2023)Local HMO$3,400$0
5
Peoples Health Choices (PPO) (2023)Local PPO$6,700$100
New plan - not yet rated.
Peoples Health Patriot (PPO) (2023)Local PPO *$6,700$-
New plan - not yet rated.
Blue Advantage (PPO) (2023)Local PPO$3,500$0
5
WellCare Compass (HMO) (2023)Local HMO$3,400$445
5
WellCare Baton Rouge Preferred (HMO) (2023)Local HMO$3,400$0
5
WellCare Endurance (HMO) (2023)Local HMO$3,400$0
5
HumanaChoice H5216-064 (PPO) (2023)Local PPO$6,700$0
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
Medicare Advantage Plans by Allwell
Allwell Medicare (HMO) (2023)Local HMO$7,550$0
New plan - not yet rated.

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