Medicare Plus Blue PPO Assure (PPO) in Saginaw, Michigan (2023)
Medicare Plus Blue PPO Assure (PPO) in Saginaw County, Michigan costs $200/mo. This affordable Regional PPO plan (H9572-003) is a top choice for those living in Saginaw County with a $0 prescription deductible and out-of-pocket limits at $3,425. Learn more about Medicare Part C by AARP in Saginaw County, Michigan below.
Read moreUPDATED: Sep 21, 2023
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5 out of 5 stars* for plan year 2024
Plan ID: H9572-003
What You Need to Know:
- Medicare Plus Blue PPO Assure (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 $200, 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 $3,425 per year (in-network).
- Medicare Plus Blue PPO Assure (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 $50.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$200
Monthly Premium
Medicare Plan Features | |||||||||
---|---|---|---|---|---|---|---|---|---|
Monthly Premium: | $200.00 | ||||||||
Part C Premium: | $206.2 | ||||||||
Monthly Premium: | Part C Premium: | Part D Drug Premium: | Part D Supplemental Premium: | Total Part D Premium: | Drug Deductible: | Tiers with No Deductible: | |||
$200.00 | $206.2 | $49.50 | $44.30 | $93.80 | $0 | 0.0 | |||
Gap Coverage: | Yes | ||||||||
Benchmark: | not below the regional benchmark | ||||||||
Type of Medicare Health: | Enhanced Alternative | ||||||||
Health Plan Type: | Local PPO | ||||||||
Similar Plan: | H9572-004 | ||||||||
Special Needs Type: | NULL | ||||||||
Chronic Condition: | NULL | ||||||||
Additional Gap Coverage: | Yes, some additional gap coverage. | ||||||||
Maximum Out-of-Pocket Limit for Parts A & B (Moop): | $3,425 | ||||||||
Annual Deductible: | NULL | ||||||||
Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
Number of Members enrolled in this plan in Saginaw, Michigan: | Plans Summary Star Rating: | Customer Service Rating: | Drug Cost Rating: | ||||||
120 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: | 3,501 drugs | ||||||||
Number of Members Enrolled in this Plan in Saginaw, 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 | ||||||
$206.20 | $49.50 | $44.30 | $300.00 | ||||||
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 | |||
$269.90 | $86.30 | $292.50 | $78.80 | $285.00 | $71.20 | $277.40 | |||
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) |
324 | $1.00 | 1287 | $7.00 | 342 | $37.00 | 656 | 45% | 690 | 33% |
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