Shuman Roy is an entrepreneur, business owner, and musician. He started RoysNoys, LLC in 2013 as a music production and education service company. He also offers small business consulting and advisory services to help businesses get from start-up mode to turn-key operations. Shuman earned his M.B.A from the Stern School of Business in 2001 and has an undergraduate degree from Manhattan College in ...

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Joel Ohman is the CEO of a private equity-backed digital media company. He is a CERTIFIED FINANCIAL PLANNER™, author, angel investor, and serial entrepreneur who loves creating new things, whether books or businesses. He has also previously served as the founder and resident CFP® of a national insurance agency, Real Time Health Quotes. He has an MBA from the University of South Florida. Joel...

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Reviewed by Joel Ohman
Founder, CFP®

UPDATED: Oct 29, 2021

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The Highlights

  • There are 26 plans that cost the same as your original Medicare in CT
  • If you choose Medicare Advantage, you’ll still need to pay your Connecticut original Medicare premium
  • There are 8 Medicare Avantage companies in Connecticut

There are several options in Connecticut for Medicare Advantage plans. Medicare Advantage (Medicare Part C) is offered by eight companies in Connecticut; and options such as HMO, PPO, and POS may be available depending on which county you live in.

To make sure you’re getting the best CT Medicare provider and plan for your needs, compare rates and out-of-pocket costs to find the ideal coverage and cost combination for you.

If you’re ready to compare Medicare plans from the top companies in your county or across Connecticut, enter your ZIP code for fast, free CT Medicare quotes today.

The Complete List of Connecticut Medicare Advantage Companies

There are many companies offering Part C Medicare Advantage in CT. Below, you’ll find a complete listing of health insurance companies that offer Medicare Advantage plans in Connecticut, the counties those plans are offered in, and the number of plans each company offers.

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Medicare Advantage Companies in Connecticut

Company Number of Plans Counties
Aetna 1 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex
Aetna Medicare 5 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex
Anthem 4 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex
Anthem Blue Cross and Blue Shield 5 Windham, Fairfield, Litchfield, New Haven, Hartford, Middlesex, New London, Tolland
CarePartners of Connecticut 4 Windham, New London, Litchfield, New Haven, Hartford, Tolland, Middlesex
ConnectiCare 10 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex
UnitedHealthcare 9 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex
WellCare 7 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex

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Connecticut Medicare Advantage Plans by Company

We’ve put together a list of all of plans available from each CT Medicare company to help you compare Medicare Advantage plans by company in Connecticut. Take a look at the plans here.

Medicare Plans in Connecticut Offered by ConnectiCare

Though plans can vary from county to county, ConnectiCare offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
ConnectiCare Choice Dual Basic (HMO D-SNP) H3276-002 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
ConnectiCare Choice Plan 3 (HMO) H3528-014 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
ConnectiCare Choice Part B Saver (HMO) H3528-017 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
ConnectiCare Choice Plan 2 (HMO) H3528-003 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO * $0.00
ConnectiCare Flex Plan 1 (HMO-POS) H3528-006 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $241.00
ConnectiCare Flex Plan 3 (HMO-POS) H3528-011 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $69.00
ConnectiCare Flex Plan 2 (HMO-POS) H3528-015 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $134.00
ConnectiCare Choice Plan 1 (HMO) H3528-016 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $183.00
ConnectiCare Choice Dual (HMO D-SNP) H3276-001 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
ConnectiCare Passage Plan 1 (HMO) H3528-010 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00

Medicare Plans in Connecticut Offered by WellCare

Though plans can vary from county to county, WellCare offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
WellCare Absolute (PPO) H1914-002 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00
WellCare Access (HMO D-SNP) H0712-005 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
WellCare Freedom (HMO D-SNP) H0712-029 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
WellCare Premier (PPO) H1914-001 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00
WellCare Value (HMO) H0712-019 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
WellCare Endurance (PPO) H1914-003 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00
WellCare Compass (HMO) H0712-020 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $21.40

Medicare Plans in Connecticut Offered by Anthem Blue Cross and Blue Shield

Though plans can vary from county to county, Anthem Blue Cross and Blue Shield offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Anthem MediBlue Plus (HMO) H5854-009 Windham, Fairfield, Litchfield, New Haven, Hartford, Middlesex Local HMO $36.00
Anthem MediBlue Select (HMO) H5854-010 Windham, Fairfield, Litchfield, New Haven, Hartford, Middlesex Local HMO $0.00
Anthem MediBlue Access Select (PPO) H2836-005 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $25.00
Anthem MediBlue Extra (HMO) H5854-011 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $35.20
Anthem MediBlue Prime (HMO) H5854-015 New Haven Local HMO $0.00

Medicare Plans in Connecticut Offered by Aetna

Though plans can vary from county to county, Aetna offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Aetna Medicare Assure Plan (HMO-POS D-SNP) H5793-017 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.

Medicare Plans in Connecticut Offered by Aetna Medicare

Though plans can vary from county to county, Aetna Medicare offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Aetna Medicare Value Plan (HMO) H5793-001 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $99.00
Aetna Medicare Elite Plan (HMO) H5793-010 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
Aetna Medicare Explorer Premier Plan (PPO) H5521-013 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $99.00
Aetna Medicare Prime PCP Elite Plan (HMO) H5793-012 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
Aetna Medicare Elite Plan (PPO) H5521-157 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00

Medicare Plans in Connecticut Offered by UnitedHealthcare

Though plans can vary from county to county, UnitedHealthcare offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
AARP Medicare Advantage Choice (Regional PPO) R7444-001 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Regional PPO $49.00
UnitedHealthcare Medicare Advantage Patriot (HMO) H0755-032 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO * $0.00
UnitedHealthcare Medicare Advantage Plan 2 (HMO) H0755-031 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $29.00
UnitedHealthcare Dual Complete (PPO D-SNP) H0271-014 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00 for people who qualify for both Medicare and Medicaid.
UnitedHealthcare Medicare Advantage Plan 1 (HMO) H0755-030 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $94.00
AARP Medicare Advantage Walgreens (PPO) H3442-001 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00
UnitedHealthcare Nursing Home Plan (PPO I-SNP) H0710-026 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $36.20
UnitedHealthcare Medicare Advantage Plan 3 (HMO) H0755-033 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00
UnitedHealthcare Assisted Living Plan (PPO I-SNP) H0710-009 Fairfield, New Haven, Hartford Local PPO $35.20

Medicare Plans in Connecticut Offered by CarePartners of Connecticut

Though plans can vary from county to county, CarePartners of Connecticut offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
CarePartners Access (PPO) H0342-001 Windham, New London, Litchfield, New Haven, Hartford, Tolland, Middlesex Local PPO $0.00
CarePartners of CT CareAdvantage Premier (HMO) H5273-003 Windham, New London, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $90.00
CarePartners of CT CareAdvantage Prime (HMO) H5273-002 Windham, New London, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $30.00
CarePartners of CT CareAdvantage Preferred (HMO) H5273-001 Windham, New London, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00

Medicare Plans in Connecticut Offered by Anthem

Though plans can vary from county to county, Anthem offers these Medicare plans in Connecticut.

Plan Name Base Plan ID Counties Plan Type Monthly Premium
Anthem MediBlue Dual Advantage (HMO D-SNP) H5854-008 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
Anthem MediBlue Dual Advantage Select (HMO D-SNP) H5854-013 Windham, New London, Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $0.00 for people who qualify for both Medicare and Medicaid.
Anthem MediBlue ESRD Care (HMO-POS C-SNP) H5854-012 Fairfield, Litchfield, New Haven, Hartford, Tolland, Middlesex Local HMO $16.40
Anthem MediBlue Care To You (HMO I-SNP) H5854-014 New Haven, Hartford, Tolland, Middlesex Local HMO $7.40

Connecticut Medicare Advantage Plans With No Additional Cost

If you decide to get Medicare Advantage in Connecticut, you still have to pay your original Medicare Part B premium. Many CT Medicare companies offer Advantage plans that don’t cost any more than your original Medicare premium. Take a look at your options.

Zero-Cost {?{?state}} Medicare Advantage Plans

Plan Name County Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
AARP Medicare Advantage Walgreens (PPO) – H3442-001-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $6,700
Aetna Medicare Elite Plan (HMO) – H5793-010-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $2.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $7,550
Aetna Medicare Elite Plan (PPO) – H5521-157-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $6,700
Aetna Medicare Prime PCP Elite Plan (HMO) – H5793-012-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $6,700
Anthem MediBlue Prime (HMO) – H5854-015-0 New Haven Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 $7,550
Anthem MediBlue Select (HMO) – H5854-010-0 New Haven, Hartford, Windham, Fairfield, Middlesex, Litchfield Preferred Generic: $0.00, Generic: $14.00, Preferred Brand: $41.00, Non-Preferred Drug: $95.00, Specialty Tier: 28%, Select Care Drugs: $0.00 $6,950
CarePartners Access (PPO) – H0342-001-0 New Haven, New London, Hartford, Windham, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33%, Vaccines: $0.00 $7,550
CarePartners of CT CareAdvantage Preferred (HMO) – H5273-001-0 New Haven, New London, Hartford, Windham, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33%, Vaccines: $0.00 $7,550
ConnectiCare Choice Part B Saver (HMO) – H3528-017-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% $7,550
ConnectiCare Choice Plan 2 (HMO) – H3528-003-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland This Plan does NOT include prescription drug coverage. $6,000
ConnectiCare Choice Plan 3 (HMO) – H3528-014-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 25% $7,550
ConnectiCare Passage Plan 1 (HMO) – H3528-010-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 28% $7,550
UnitedHealthcare Medicare Advantage Patriot (HMO) – H0755-032-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland This Plan does NOT include prescription drug coverage. $6,000
UnitedHealthcare Medicare Advantage Plan 3 (HMO) – H0755-033-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% $6,700
WellCare Absolute (PPO) – H1914-002-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 33% $6,500
WellCare Endurance (PPO) – H1914-003-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $35.00, Non-Preferred Drug: 48%, Specialty Tier: 33% $6,700
WellCare Premier (PPO) – H1914-001-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 31% $5,000
WellCare Value (HMO) – H0712-019-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $1.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: 48%, Specialty Tier: 33% $5,500
UnitedHealthcare Dual Complete (PPO D-SNP) – H0271-014-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 N/A
WellCare Freedom (HMO D-SNP) – H0712-029-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $6.00, Preferred Brand: $47.00, Non-Preferred Drug: 45%, Specialty Tier: 25% N/A
WellCare Access (HMO D-SNP) – H0712-005-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Drug: 48%, Specialty Tier: 25% N/A
Aetna Medicare Assure Plan (HMO-POS D-SNP) – H5793-017-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $0.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% N/A
Anthem MediBlue Dual Advantage (HMO D-SNP) – H5854-008-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 N/A
Anthem MediBlue Dual Advantage Select (HMO D-SNP) – H5854-013-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Preferred Generic: $0.00, Generic: $19.00, Preferred Brand: $47.00, Non-Preferred Drug: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 N/A
ConnectiCare Choice Dual (HMO D-SNP) – H3276-001-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 N/A
ConnectiCare Choice Dual Basic (HMO D-SNP) – H3276-002-0 New Haven, New London, Hartford, Windham, Fairfield, Middlesex, Litchfield, Tolland Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 N/A

Standalone Medicare Part D Plans in Connecticut

There is a wide variety of Medicare Part D plans available in every state, and Connecticut is no exception. Keep in mind that plans vary by county, and don’t forget to check that your CT Medicare Advantage plan doesn’t already include Part D prescription drug coverage.

Standalone Medicare Part D Plans in Connecticut

Plan Details Tiers
AARP MedicareRx Preferred (PDP)
S5820 – 002 – 0
by UnitedHealthcare
Monthly Premium: $86.00
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $10.00
Tier 3: $45.00
Tier 4: 40%
Tier 5: 33%
AARP MedicareRx Saver Plus (PDP)
S5921 – 348 – 0
by UnitedHealthcare
Monthly Premium: $31.90
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $5.00
Tier 3: $31.00
Tier 4: 40%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 385 – 0
by UnitedHealthcare
Monthly Premium: $37.90
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Blue MedicareRx Premier (PDP)
S2893 – 003 – 0
by Anthem Blue Cross and Blue Shield
Monthly Premium: $135.00
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $1.00
Tier 2: $7.00
Tier 3: $30.00
Tier 4: 35%
Tier 5: 33%
Blue MedicareRx Value Plus (PDP)
S2893 – 001 – 0
by Anthem Blue Cross and Blue Shield
Monthly Premium: $50.50
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $36.00
Tier 4: 40%
Tier 5: 25%
Cigna Secure Rx (PDP)
S5617 – 008 – 0
by Cigna
Monthly Premium: $36.50
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $41.00
Tier 4: 50%
Tier 5: 25%
Cigna Secure-Essential Rx (PDP)
S5617 – 281 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 18%
Tier 4: 49%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 247 – 0
by Cigna
Monthly Premium: $40.90
Annual Deductible: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $4.00
Tier 2: $10.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Elixir RxPlus (PDP)
S7694 – 125 – 0
by Elixir Insurance
Monthly Premium: $14.30
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $43.00
Tier 4: 45%
Tier 5: 25%
Elixir RxSecure (PDP)
S7694 – 002 – 0
by Elixir Insurance
Monthly Premium: $34.40
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $7.00
Tier 3: 15%
Tier 4: 32%
Tier 5: 25%
Express Scripts Medicare – Choice (PDP)
S5660 – 206 – 0
by Express Scripts Medicare
Monthly Premium: $76.40
Annual Deductible: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Express Scripts Medicare – Saver (PDP)
S5660 – 219 – 0
by Express Scripts Medicare
Monthly Premium: $27.40
Annual Deductible: $285
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $35.00
Tier 4: 50%
Tier 5: 28%
Express Scripts Medicare – Value (PDP)
S5660 – 105 – 0
by Express Scripts Medicare
Monthly Premium: $32.80
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $30.00
Tier 4: 50%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 102 – 0
by Humana
Monthly Premium: $35.10
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $1.00
Tier 3: 20%
Tier 4: 35%
Tier 5: 25%
Humana Premier Rx Plan (PDP)
S5884 – 149 – 0
by Humana
Monthly Premium: $65.40
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $45.00
Tier 4: 49%
Tier 5: 25%
Humana Walmart Value Rx Plan (PDP)
S5884 – 182 – 0
by Humana
Monthly Premium: $17.20
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: 17%
Tier 4: 35%
Tier 5: 25%
Mutual of Omaha Rx Plus (PDP)
S7126 – 002 – 0
by Mutual of Omaha Rx
Monthly Premium: $87.10
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 39%
Tier 5: 25%
Mutual of Omaha Rx Premier (PDP)
S7126 – 072 – 0
by Mutual of Omaha Rx
Monthly Premium: $25.10
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 23%
Tier 4: 45%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 004 – 0
by Aetna Medicare
Monthly Premium: $32.90
Annual Deductible: $225
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $35.00
Tier 4: 41%
Tier 5: 29%
SilverScript Plus (PDP)
S5601 – 005 – 0
by Aetna Medicare
Monthly Premium: $72.00
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $47.00
Tier 4: 45%
Tier 5: 33%
SilverScript SmartRx (PDP)
S5601 – 177 – 0
by Aetna Medicare
Monthly Premium: $7.20
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $19.00
Tier 3: $46.00
Tier 4: 49%
Tier 5: 25%
WellCare Classic (PDP)
S4802 – 076 – 0
by WellCare
Monthly Premium: $31.00
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 34%
Tier 5: 25%
WellCare Medicare Rx Saver (PDP)
S5810 – 036 – 0
by WellCare
Monthly Premium: $35.70
Annual Deductible: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $42.00
Tier 4: 37%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 276 – 0
by WellCare
Monthly Premium: $26.40
Annual Deductible: $400
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $47.00
Tier 4: 42%
Tier 5: 25%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 126 – 0
by WellCare
Monthly Premium: $74.40
Annual Deductible: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $47.00
Tier 4: 47%
Tier 5: 33%
WellCare Value Script (PDP)
S4802 – 137 – 0
by WellCare
Monthly Premium: $16.20
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 171 – 0
by WellCare
Monthly Premium: $14.40
Annual Deductible: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $40.00
Tier 4: 46%
Tier 5: 25%

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