Anthem MediBlue Core (HMO) in Fayette, Georgia (2023)
Anthem MediBlue Core (HMO) in Fayette County, Georgia costs $0/mo. This affordable Regional PPO plan (H5422-014) is a top choice for those living in Fayette County with out-of-pocket limits at $7,550. Learn more about Medicare Part C by AARP in Fayette County, Georgia below.
UPDATED: Sep 19, 2023
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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 Fayette, 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 Fayette, 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 |
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