5

5 out of 5 stars* for plan year 2024

Plan ID: H4875-020

What You Need to Know:

  • PriorityMedicare Edge (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 $5,300 per year (in-network).
  • PriorityMedicare Edge (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: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H4875-021
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): $5,300
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Muskegon, Michigan: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
1,175 members 3.5 out of 5 Stars. 5 out of 5 Stars. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,697 drugs
Number of Members Enrolled in this Plan in Muskegon, Michigan: NULL
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)
292 $2.00 1610 $8.00 318 $38.00 669 40% 808 33%

Other Medicare Advantage Plans in Muskegon, Michigan

Plan Name Type Premium MOOP Rx Deduct. Rating
Humana Honor (PPO) (2023)Local PPO *$5,500$-
4
WellCare Essential (HMO-POS) (2023)Local HMO$3,450$0
5
Aetna Medicare Premier (PPO) (2023)Local PPO$6,000$0
5
BCN Advantage HMO-POS Classic (HMO-POS) (2023)Local HMO$3,800$0
5
Aetna Medicare Value (PPO) (2023)Local PPO$6,725$0
5
HumanaChoice H8087-001 (PPO) (2023)Local PPO$5,900$75
5
Aetna Medicare Eagle (PPO) (2023)Local PPO *$5,900$-
5
BCN Advantage HMO-POS Prestige (HMO-POS) (2023)Local HMO$3,400$0
5
PriorityMedicare Select (PPO) (2023)Local PPO$3,500$0
5
PriorityMedicare Ideal (PPO) (2023)Local PPO$5,800$125
5
PriorityMedicare Vital (PPO) (2023)Local PPO$6,000$350
5
HAP Choice Medicare - West Michigan Option 1 (HMO) (2023)Local HMO$4,800$0
4
HAP Choice Medicare - West Michigan Option 2 (HMO) (2023)Local HMO$3,900$0
4
HumanaChoice H5216-009 (PPO) (2023)Local PPO$5,900$0
4
Humana Gold Choice H8145-006 (PFFS) (2023)PFFS$-$445
4
HumanaChoice R3887-001 (Regional PPO) (2023)Regional PPO *$5,500$-
5
Medicare Plus Blue PPO Vitality (PPO) (2023)Local PPO$5,000$100
5
Humana Gold Choice H8145-121 (PFFS) (2023)PFFS *$-$-
4
Medicare Plus Blue PPO Assure (PPO) (2023)Local PPO$3,425$0
5
Humana Gold Plus H8908-002 (HMO) (2023)Local HMO$6,000$0
5
PriorityMedicare Value (HMO-POS) (2023)Local HMO$4,900$75
3
Medicare Plus Blue PPO Signature (PPO) (2023)Local PPO$4,700$0
5
HumanaChoice R3887-002 (Regional PPO) (2023)Regional PPO$5,300$380
5
Medicare Plus Blue PPO Essential (PPO) (2023)Local PPO$6,000$100
5
PriorityMedicare Key (HMO-POS) (2023)Local HMO$5,500$100
3
PriorityMedicare Merit (PPO) (2023)Local PPO$4,100$0
5
BCN Advantage Prime Value (HMO-POS) (2023)Local HMO$4,500$50
5
BCN Advantage HMO-POS Elements (HMO-POS) (2023)Local HMO *$4,500$-
5
WellCare Dividend (HMO) (2023)Local HMO$3,450$445
5
PriorityMedicare (HMO-POS) (2023)Local HMO$4,500$0
3
Medicare Advantage Plans by Priority Health Medicare
PriorityMedicare Select (PPO) (2023)Local PPO$3,500$0
5
PriorityMedicare Ideal (PPO) (2023)Local PPO$5,800$125
5
PriorityMedicare Vital (PPO) (2023)Local PPO$6,000$350
5
PriorityMedicare Value (HMO-POS) (2023)Local HMO$4,900$75
3
PriorityMedicare Key (HMO-POS) (2023)Local HMO$5,500$100
3
PriorityMedicare Merit (PPO) (2023)Local PPO$4,100$0
5
PriorityMedicare (HMO-POS) (2023)Local HMO$4,500$0
3

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