Plan ID: H6529-001

What You Need to Know:

  • MyTruAdvantage Select (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 .
  • The plan includes an out-of-pocket maximum of $4,500 per year (in-network).
  • MyTruAdvantage Select (HMO) 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.

$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: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local HMO
Similar Plan: H6529-001
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $4,500
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Bartholomew, Indiana: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
20 members New plan - No summary rating as of yet. New plan - not yet rated. New plan - not yet rated.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,388 drugs
Number of Members Enrolled in this Plan in Bartholomew, Indiana: 221 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)
340 $0.00 441 $7.00 1054 $42.00 885 $95.00 668 33%

Other Medicare Advantage Plans in Bartholomew, Indiana

Plan Name Type Premium MOOP Rx Deduct. Rating
AARP Medicare Advantage Plan 1 (HMO-POS) (2023)Local HMO$3,900$0
5
Anthem MediBlue Access Plus (PPO) (2023)Local PPO$6,400$60
5
Anthem MediBlue Extra (HMO) (2023)Local HMO$6,700$445
4
Anthem MediBlue Access Basic (Regional PPO) (2023)Regional PPO$6,400$100
5
AARP Medicare Advantage Choice Plan 1 (PPO) (2023)Local PPO$5,200$185
5
Anthem MediBlue Access Preferred (PPO) (2023)Local PPO$4,900$125
5
AARP Medicare Advantage Choice Plan 2 (PPO) (2023)Local PPO$5,500$185
5
Anthem MediBlue Plus (HMO) (2023)Local HMO$4,900$75
4
HumanaChoice H5216-111 (PPO) (2023)Local PPO$4,900$100
4
AARP Medicare Advantage Choice Premier (PPO) (2023)Local PPO$7,550$445
5
HumanaChoice R0865-003 (Regional PPO) (2023)Regional PPO$6,700$195
4
MyTruAdvantage Choice (PPO) (2023)Local PPO$5,000$100
New plan - not yet rated.
IU Health Plans Medicare Select (HMO) (2023)Local HMO *$5,000$-
4
HumanaChoice R0865-001 (Regional PPO) (2023)Regional PPO *$6,200$-
4
HumanaChoice H5216-192 (PPO) (2023)Local PPO$7,550$250
4
Humana Gold Plus H5619-049 (HMO) (2023)Local HMO$3,900$0
4
Allwell Medicare Complement (HMO) (2023)Local HMO$5,500$445
New plan - not yet rated.
Humana Gold Plus H5619-124 (HMO) (2023)Local HMO$3,900$0
4
HumanaChoice H5216-054 (PPO) (2023)Local PPO$5,900$0
4
IU Health Plans Medicare Select Plus (HMO) (2023)Local HMO$4,950$200
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$5,500$-
5
Medicare Advantage Plans by MyTruAdvantage
MyTruAdvantage Choice (PPO) (2023)Local PPO$5,000$100
New plan - not yet rated.

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