4

4 out of 5 stars* for plan year 2024

Plan ID: H5613-002

What You Need to Know:

  • MVP SmartFund (MSA) is a Medicare Advantage Health Maintenance Organization MSA * 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 N/A, 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 $- per year (in-network).
  • MVP SmartFund (MSA) 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.

N/A

Monthly Premium

Medicare Plan Features
Monthly Premium: NULL
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:
NULL NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: MSA *
Similar Plan: H5613-002
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $-
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Cortland, New York: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
less than 10 members Insufficient data to rate this plan. -4 out of 5 Stars. -4 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 Cortland, New York: 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
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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WellCare Today's Options Premier 200 (PFFS) (2023)PFFS *$-$-
5
MVP Medicare Secure Plus with Part D (HMO-POS) (2023)Local HMO$7,550$0
4
WellCare Absolute (PPO) (2023)Local PPO$7,550$150
5
HumanaChoice H5970-001 (PPO) (2023)Local PPO$5,500$0
4
Medicare BlueSecure (PPO) (2023)Local PPO$6,700$0
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WellCare Today's Options Premier 300 (PFFS) (2023)PFFS *$-$-
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Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$7,550$-
5
MVP Medicare Secure with Part D (HMO-POS) (2023)Local HMO$7,550$150
4
Aetna Medicare Premier Plan (PPO) (2023)Local PPO$7,550$200
5
Humana Gold Plus H3533-001 (HMO) (2023)Local HMO$7,200$350
4
Medicare BlueEnhanced (PPO) (2023)Local PPO$5,000$0
5
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5
WellCare Summit (PPO) (2023)Local PPO$6,700$445
5
Medicare BlueClassic (PPO) (2023)Local PPO$7,200$0
5
Aetna Medicare Value Plan (HMO) (2023)Local HMO$7,550$0
5
MVP Medicare Preferred Gold without Part D (HMO-POS) (2023)Local HMO *$7,550$-
4
Medicare BlueBasic (PPO) (2023)Local PPO *$4,500$-
5
WellCare Today's Options Premier Plus 250A (PFFS) (2023)PFFS$-$0
5
Medicare BlueEssential (PPO) (2023)Local PPO$7,550$150
5
WellCare Today's Options Advantage Plus 550B (PPO) (2023)Local PPO$6,700$0
5
WellCare Today's Options Premier Plus 650B (PFFS) (2023)PFFS$-$0
5
MVP Medicare Preferred Gold with Part D (HMO-POS) (2023)Local HMO$5,800$0
4
Medicare Advantage Plans by MVP HEALTH CARE
MVP Medicare WellSelect Plus with Part D (PPO) (2023)Local PPO$6,500$0
4
MVP Medicare WellSelect with Part D (PPO) (2023)Local PPO$7,550$325
4
MVP Medicare Secure Plus with Part D (HMO-POS) (2023)Local HMO$7,550$0
4
MVP Medicare Secure with Part D (HMO-POS) (2023)Local HMO$7,550$150
4
MVP Medicare Preferred Gold without Part D (HMO-POS) (2023)Local HMO *$7,550$-
4
MVP Medicare Preferred Gold with Part D (HMO-POS) (2023)Local HMO$5,800$0
4

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