2023 Ohio Medicare Advantage plans are available through multiple companies. MA Coverage and rates vary, depending on the type of contract you choose, your age, and which part of the Buckeye State you live. Senior Medigap benefits help reduce your out-of-pocket expenses while providing many different types of benefits. Plans (referred to as C or MA plans) are offered through private carriers with emergency benefits included in and outside of the service area. HMO, PPO,PFFS, and SNP plans can be purchased.

Listed below are Advantage contracts offered to individuals that qualify for enrollment. Generally, Seniors that have reached age 65 and have signed up for Part B may be eligible for a policy. A six-month period begins the month you reach age 65, regardless of any medical conditions. A separate Open Enrollment period also begins on October 15th and ends on December 7th each year. Ohio Medigap plans and rates can also be viewed. Supplement plans are also reviewed through our website.

Most plans include prescription drug benefits. For plans that don’t include Rx coverage, Part D contracts can be purchased stand-alone with their own formulary lists. Different tiers are provided, with the lowest tiers featuring the cheapest costs, often with copays of $5 and less. Several prescriptions not covered under Part D plans include weight-gain and weight-loss drugs, minerals and vitamins, barbiturates, and testing strips for blood glucose.

Additional new benefits for diabetes patients are available through many plans. Transportation to a physician’s appointment or diabetes education program, and meetings with a nutritionist can now be covered. Cooking classes for improving a diet might also be covered, depending upon the carrier. For asthma sufferers, carpet cleaning and home air cleaners may be a covered benefit. Additional covered expenses may include home improvements such as wider hallways and permanent ramps.

During pandemics (including COVID-19), additional assistance is provided that includes updated information on benefits and policy coverage. The “Part D Senior Savings Model” provides lower insulin costs and 12 acupuncture visits (every 90 days) is available for chronic lower back pain.

Prices, deductibles, copays, and availability can vary depending upon your county of residence. Often, vision, hearing, and dental benefits are included. Enhanced comprehensive dental coverage may also be offered for an extra cost. An “Annual Notice Of Change” (ANOC) will inform you of changes in costs and benefits that are effective in January. The “Evidence Of Coverage” (EOC) provides specific information regarding rates and coverage.

New Ohio MA Plans For 2023

Cigna Preferred Medicare

Cigna Preferred Plus Medicare

Cigna Preferred Savings Medicare

Cigna True Choice Courage Medicare

Cigna True Choice Medicare

CommuniCare Advantage CNSP

Devoted Choice Ohio

Devoted Core Ohio

Devoted Dual Ohio

Devoted Giveback Ohio

Essence Advantage

Essence Advantage Choice

Essence Advantage Plus

Humana USAA Honor With Rx

MAP Medicare

MediGold Mount Carmel No Premium

MediGold Mount Carmel Cash Back No Premium

MediGold Mount Carmel Plus

MediGold Mount Carmel Premier

Molina Medicare Choice Care Select

Molina Medicare

Paramount Elite Essential

Paramount Elite NE Ohio Standard

Paramount Elite NE Ohio Enhanced

Perennial Advantage Freedom

Wellcare Patriot Giveback Open

Wellcare Dual Access Open

SummaCare Medicare Jade With Bene-Flex TM

 

Ohio Counties With Most MA Plan Options

113 – Summit County

112 – Cuyahoga County

109 – Lake County

107 – Stark County

107 – Hamilton County

106 – Medina County

106 – Lorain County

105 – Trumbull County

105 – Butler County

104 – Montgomery County

103 – Mahoning County

101 – Portage County

99 – Clermont County

99 – Warren County

98 – Lucas County

98 – Greene County

94 – Clark County

94 – Columbiana County

94 – Miami County

 

Ohio Counties With Least MA Plan Options

38 – Ashtabula County

47 – Lawrence County

48 – Meigs County

49 – Athens County

49 – Scioto County

53 – Belmont County

54 – Gallia County

59 – Jackson County

59 – Vinton County

60 – Logan County

60 – Noble County

61 – Ross County

61 – Monroe County

61 – Hardin County

62 – Paulding County

62 – Hocking County

63 – Guernsey County

63 – Mercer County

63 – Marion County

 

AARP Medicare Advantage Flex Plan 8 – $25 per month premium and $0 deductible. HMO with $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 5 days. Outpatient hospital copay is $0-$325. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $131 (Tier 3 preferred generic), $290 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Plan Star rating is 4.5. 3,682 formulary drugs available.

AARP Medicare Advantage Patriot – $0 per month premium. Local PPO with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $275 for the first 5 days. Outpatient hospital copay is $0-$275. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $30-$40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. Prescription drug coverage is not included. Plan Star rating is 4.0.

AARP Medicare Advantage Plan 7 – $0 per month premium and $0 deductible. HMO with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 5 days. Outpatient hospital copay is $0-$325. Pcp and specialist office visit copays are $5 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $12 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $131 (Tier 3 preferred generic), $290 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Plan Star rating is 4.5. 3,682 formulary drugs available.

AARP Medicare Advantage Choice Plan 4 – $0 per month premium and $0 deductible. PPO with $5,900 maximum out-of-pocket expenses. Inpatient hospital copay is $385 for the first 5 days. Outpatient hospital copay is $0-$315. Pcp and specialist office visit copays are $5 and $25. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $12 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $131 (Tier 3 preferred generic), $290 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Plan Star rating is 4.0. 3,682 formulary drugs available.

AARP Medicare Advantage Plan 3 – $109 per month premium and $0 deductible. HMO with $3,400 maximum out-of-pocket expenses. Inpatient hospital copay is $225 for the first 4 days. Outpatient hospital copay is $0-$225. Pcp and specialist office visit copays are $5 and $25. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $8 (Tier 2 generic), $45 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $125 (Tier 3 preferred generic), $275 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental benefits (exams, cleanings, and x-rays) are included with a $0 copay. Plan Star rating is 4.5. 3,682 formulary drugs available.

AARP Medicare Advantage Plan 2 – $18 per month premium and $0 deductible. HMO with $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 4 days. Outpatient hospital copay is $0-$295. Pcp and specialist office visit copays are $0 and $25. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $45 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $125 (Tier 3 preferred generic), $275 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental benefits (exams, cleanings, and x-rays) and diagnostic services are included with a $0 copay. Plan Star rating is 4.5. 3,682 formulary drugs available.

AARP Medicare Advantage Plan 1 – $19 per month premium and $0 deductible. HMO with $3,500 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 4 days. Outpatient hospital copay is $0-$295. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $15 copay. Outpatient individual and group mental health therapy visits are $25 and $15. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $45 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $125 (Tier 3 preferred generic), $275 (Tier 4 non-preferred), and 30% (Tier 5 specialty). Preventative dental benefits (exams, cleanings, and x-rays) are included with a $0 copay. Plan Star rating is 4.5. 3,708 formulary drugs available.

Aetna Medicare Advantra Silver – $0 per month premium and $0 deductible. PPO with $4,900 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital copay is $0-$285. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $0-$45 and $110. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $5-$90 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $20 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental benefits (exams, cleanings, and x-rays) and many other services are included with a $0 copay. Plan Star rating is 3.5. 3,612 formulary drugs available.

Aetna Medicare Value Plan (HMO) – $0 per month premium and $150 deductible. PPO with $6,700 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 4 days. Outpatient hospital copay is $0-$350. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $0-$45 and $95. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $0-$110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 30% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $20 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental (and some comprehensive) benefits are included. Plan Star rating is 3.5. 3,612 formulary drugs available.

 

 

 

Aetna Medicare Value Plan (PPO) – $0 per month premium and $150 deductible. PPO with $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 4 days. Outpatient hospital copay is $0-$350. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $0-$45 and $95. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $0-$110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $20 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental (and some comprehensive) benefits are included. Plan Star rating is 3.5. 3,612 formulary drugs available.

 

 

 

 

 

 

Aetna Medicare Premier 1 – $149 per month premium and $150 deductible. PPO with $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $220 for the first 6 days. Outpatient hospital copay is $0-$130. Pcp and specialist office visit copays are $10 and $35. Urgent Care and ER copays are $10-$45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $20 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 30% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits are not provided. Plan Star rating is 4.5.

Aetna Medicare Premier Plus 1 – $217 per month premium and $0 deductible. Regional PPO with $4,900 maximum out-of-pocket expenses. Inpatient hospital copay is $200 for the first 5 days. Outpatient hospital copay is $0-$100. Pcp and specialist office visit copays are $10 and $35. Urgent Care and ER copays are $10-$45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $20 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $42 (Tier 3 preferred generic), $99 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $126 (Tier 3 preferred generic), $297 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits are not provided. Plan Star rating is 4.0.

Aetna Medicare Premier 2 – $118 per month premium and $0 deductible. PPO with $4,800 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 6 days. Outpatient hospital copay is $0-$170. Pcp and specialist office visit copays are $5 and $35. Urgent Care and ER copays are $5-$50 and $90. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $5-$50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits provided subject to policy limits. Plan Star rating is 4.5.

Aetna Medicare Premier Plus 2 – $179 per month premium and $260 deductible. PPO with $5,100 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital copay is $0-$200. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $0-$45 and $90. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $0-$20 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 28% (Tier 5 specialty). 90-Day mail-order prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits provided subject to policy limits. Plan Star rating is 4.0.

Anthem MediBlue Preferred – $0 per month premium and $0 deductible. HMO with $3,800 maximum out-of-pocket expenses. Inpatient hospital copay is $310 for the first 7 days. Outpatient hospital copay is $0-$285. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $30 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $35. 30-Day prescription drug copays are $4 (Tier 1 preferred generic), $10 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $12 (Tier 1 preferred generic), $30 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental benefits are included. Plan Star rating is 4.0.

Anthem MediBlue Access – $56 per month premium and $0 deductible. PPO with $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $275 for the first 6 days. Outpatient hospital copay is $0 or 20%. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $35 and $90. Lab services are subject to a $0-15 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $4 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $12 (Tier 1 preferred generic), $45 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Dental, vision, hearing, and foot coverage are included subject to policy limitations. Plan Star rating is 4.5.

Anthem MediBlue Access Basic – $83 per month premium and $200 deductible. Regional PPO with $6,000 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 7 days. Outpatient hospital copay is $0 or 20%. Pcp and specialist office visit copays are $10 and $40. Urgent Care and ER copays are $35 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $6 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), 41% (Tier 4 non-preferred), and 29% (Tier 5 specialty). 90-Day prescription drug copays are $18 (Tier 1 preferred generic), $45 (Tier 2 generic), $126 (Tier 3 preferred generic), 41% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Preventative dental benefits are available for an additional $20 per month. Plan Star rating is 4.0.

Anthem MediBlue Access Plus – $89 per month premium and $40 deductible. PPO with $4,300 maximum out-of-pocket expenses. Inpatient hospital copay is $270 for the first 8 days. Outpatient hospital copay is $0 or 15%. Pcp and specialist office visit copays are $0 and $30. Urgent Care and ER copays are $25 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $4 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 32% (Tier 5 specialty). 90-Day prescription drug copays are $12 (Tier 1 preferred generic), $45 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Three dental options are available at a cost of $20, $31, and $51 per month. Plan Star rating is 4.5.

Anthem MediBlue Prime Select – $0 per month premium and $0 deductible. HMO with $3,450 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 6 days. Outpatient hospital copay is $0-$275. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $30 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $2 (Tier 1 preferred generic), $12 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $6 (Tier 1 preferred generic), $36 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Three dental options are available at a cost of $14, $27, and $42 per month. Plan Star rating is 4.0.

Anthem MediBlue Preferred Plus – $19 per month premium and $0 deductible. HMO with $3,650 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital copay is $0-$295. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $30 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $4 (Tier 1 preferred generic), $10 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $12 (Tier 1 preferred generic), $30 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Three dental options are available at a cost of $14, $27, and $42 per month. Plan Star rating is 4.0.

Anthem MediBlue Extra – $22.00 per month premium and $480 deductible. HMO with $7,550 maximum out-of-pocket expenses. Inpatient hospital copay is $310 for the first 7 days. Outpatient hospital copay is $0 or 20%. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $35 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-90 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $7 (Tier 2 generic), $47 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 25% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $21 (Tier 2 generic), $141 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Three dental options are available at a cost of $14, $27, and $42 per month. Plan Star rating is 4.0.

Anthem MediBlue Acess Core – $0 per month premium. Regional PPO with $4,900 maximum out-of-pocket expenses. Inpatient hospital copay is $255 for the first 8 days. Outpatient hospital copay is $0-$225. Pcp and specialist office visit copays are $0 and $30. Urgent Care and ER copays are $25 and $90. Lab services are subject to a $0-$15 copay, and outpatient x-rays are subject to a $50-110 copay. Outpatient individual and group mental health therapy visits are $40. Prescription coverage is not included.  Three dental options are available at a cost of $20, $31, and $51 per month. Plan Star rating is 4.0.

Anthem MediBlue Plus – $55 per month premium and $0 deductible. HMO with $4,100 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 6 days. Outpatient hospital copay is $0-$225. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $30 and $90. Lab services are subject to a $0-10 copay, and outpatient x-rays are subject to a $50-100 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $2 (Tier 1 preferred generic), $10 (Tier 2 generic), $37 (Tier 3 preferred generic), $90 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $6 (Tier 1 preferred generic), $30 (Tier 2 generic), $111 (Tier 3 preferred generic), $270 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Three dental options are available at a cost of $14, $27, and $42 per month. Plan Star rating is 4.0.

CareSource Advantage Zero Premium – $0 per month premium and $150 deductible. HMO with $7,550 maximum out-of-pocket expenses. Inpatient hospital copay is $380 for the first 5 days. Outpatient hospital coinsurance is $295. Pcp and specialist office visit copays are $15 and $50. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $35 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $5 (Tier 1 preferred generic), $15 (Tier 2 generic), $45 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 30% (Tier 5 specialty). 90-Day prescription drug copays are $15 (Tier 1 preferred generic), $45 (Tier 2 generic), $135 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Some preventative dental coverage included. Plan Star rating is 3.5.

CareSource Advantage – $25 per month premium and $75 deductible. HMO with $5,600 maximum out-of-pocket expenses. Inpatient hospital copay is $285 for the first 7 days. Outpatient hospital coinsurance is $295. Pcp and specialist office visit copays are $0 and $0-$35. Urgent Care and ER copays are $35 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $25 copay. Outpatient individual and group mental health therapy visits are $35. 30-Day prescription drug copays are $4 (Tier 1 preferred generic), $10 (Tier 2 generic), $45 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 31% (Tier 5 specialty). 90-Day prescription drug copays are $12 (Tier 1 preferred generic), $30 (Tier 2 generic), $135 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Some dental coverage included with 30%-50% coinsurance. Plan Star rating is 3.5.

Cigna Preferred Medicare – $0 per month premium and $0 deductible. HMO with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $335 for the first 6 days. Outpatient hospital coinsurance is $0-$335. Pcp and specialist office visit copays are $0 and $30. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $0. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Some dental coverage included. No Plan Star rating.

Cigna True Choice Medicare – $0 per month premium and $0 deductible. HMO with $5,500 maximum out-of-pocket expenses. Inpatient hospital copay is $360 for the first 5 days. Outpatient hospital coinsurance is $0-$345. Pcp and specialist office visit copays are $0 and $30. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $60 copay. Outpatient individual and group mental health therapy visits are $0. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Some dental coverage included. Plan Star rating is 3.5.

Devoted Health Prime – $31 per month premium and $0 deductible. HMO with $4,100 maximum out-of-pocket expenses. Inpatient hospital copay is $295vfor the first 7 days. Outpatient hospital coinsurance is $0-$295. Pcp and specialist office visit copays are $0 and $25. Urgent Care and ER copays are $0-$25 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $0-$25 copay. Outpatient individual and group mental health therapy visits are $25. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Some dental coverage included.

Humana Honor  – $0 per month premium and $0 deductible. PPO with $5,900 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital coinsurance is $0-$325. Pcp and specialist office visit copays are $15 and $45. Urgent Care and ER copays are $15-$45 and $90. Lab services are subject to a $0-$35 copay, and outpatient x-rays are subject to a $15-$110 copay. Outpatient individual and group mental health therapy visits are $30. Prescription drug benefits are not provided. Plan Star rating is 4.0.

Humana Gold Plus – $0 per month premium and $0 deductible. Local HMO with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital copay is $0-$325. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $0-$40 and $90. Lab services are subject to a $0-$35 copay, and outpatient x-rays are subject to a $0-$110 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $2 (Tier 1 preferred generic), $8 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $6 (Tier 1 preferred generic), $24 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Two comprehensive dental options are offered at monthly rates of $23.80 and $34.10. Plan Star rating is 4.5.

Humana Gold Choice – $83.00 per month premium and $225 deductible.  Inpatient hospital copay is $390 for the first 5 days. Outpatient hospital coinsurance is $0-$365. Pcp and specialist office visit copays are $20-$50. Urgent Care and ER copays are $20-$50 and $90. Lab services are subject to a $0-$35 copay, and outpatient x-rays are subject to a $20-$110 copay. Outpatient individual and group mental health therapy visits are subject to a $40 copay. 30-Day prescription drug copays are $7 (Tier 1 preferred generic), $17 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 29% (Tier 5 specialty). 90-Day prescription drug copays are $21 (Tier 1 preferred generic), $51 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Plan Star rating is 4.0.

Humana Cleveland Clinic Preferred – $0 per month premium and $0 deductible. Local HMO with $3,900 maximum out-of-pocket expenses. Inpatient hospital copay is $350 for the first 5 days. Outpatient hospital copay is $25-$300. Pcp and specialist office visit copays are $0 and $25. Urgent Care and ER copays are $0-$25 and $90. Lab services are subject to a $0-$25 copay, and outpatient x-rays are subject to a $0-$110 copay. Outpatient individual and group mental health therapy visits are $35. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $15 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Two comprehensive dental options are offered at monthly rates of $32 and $43.30. Plan Star rating is 4.0.

MediGold Southwest OH Essential Care – $0 per month premium and $0 deductible. Local HMO with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $345 for the first 5 days. Outpatient hospital copay is $0-$265. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $35. 30-Day prescription drug copays are $2 (Tier 1 preferred generic), $5 (Tier 2 generic), $45 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $6 (Tier 1 preferred generic), $15 (Tier 2 generic), $135 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $18 and $34 per month. Plan Star rating is 4.5.

MediGold True Advantage – $49 per month premium and $0 deductible. Local HMO with $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $300 for the first 5 days. Outpatient hospital copay is $0-$175. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $20 copay. Outpatient individual and group mental health therapy visits are $30. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $45 (Tier 3 preferred generic), $75 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $30 (Tier 2 generic), $135 (Tier 3 preferred generic), $225 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $18 and $35 per month. Plan Star rating is 4.5.

MediGold Prime Choice – $0 per month premium and $150 deductible. Local HMO with $5,700 maximum out-of-pocket expenses. Inpatient hospital copay is $375 for the first 5 days. Outpatient hospital copay is $10-$300. Pcp and specialist office visit copays are $0 and $45. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $10 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $2 (Tier 1 preferred generic), $5 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 30% (Tier 5 specialty). 90-Day prescription drug copays are $6 (Tier 1 preferred generic), $15 (Tier 2 generic), $141 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $22 and $41 per month. Plan Star rating is 4.5.

MedMutual Advantage Classic – $0 per month premium and $95 deductible. Local HMO with $5,250 maximum out-of-pocket expenses. Inpatient hospital copay is $335 for the first 6 days. Outpatient hospital copay is $425. Pcp and specialist office visit copays are $5 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to $0-$10 copays, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 31% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $13 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental, plus eyewear benefits are available for an additional $22 per month. Plan Star rating is 4.5.

MedMutual Advantage Choice – $40 per month premium and $55 deductible. HMO with $4,400 maximum out-of-pocket expenses. Inpatient hospital copay is $385 for the first 5 days. Outpatient hospital copay is $420. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to $0-$10 copays, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $5 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 32% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $13 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental, plus eyewear benefits are available for an additional $22 per month. Plan Star rating is 4.5.

MedMutual Advantage Plus – $95 per month premium and $55 deductible. HMO with $3,450 maximum out-of-pocket expenses. Inpatient hospital copay is $375 for the first 6 days. Outpatient hospital copay is $240. Pcp and specialist office visit copays are $0 and $25. Urgent Care and ER copays are $25 and $120. Lab services are subject to $0-$10 copays, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $25. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 32% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental, plus eyewear benefits are available for an additional $22 per month. Plan Star rating is 4.0.

MedMutual Advantage Preferred – $74 per month premium and $55 deductible. PPO with $5,700 maximum out-of-pocket expenses. Inpatient hospital copay is $375 for the first 5 days. Outpatient hospital copay is $430. Pcp and specialist office visit copays are $5 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to $0-$10 copays, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 32% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental, plus eyewear benefits are available for an additional $22 per month. Plan Star rating is 4.5.

MedMutual Advantage Select – $38 per month premium and $95 deductible. Local PPO with $5,900 maximum out-of-pocket expenses. Inpatient hospital copay is $375 for the first 5 days. Outpatient hospital copay is $420. Pcp and specialist office visit copays are $10 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to $0-$10 copays, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 31% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $38 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental, plus eyewear benefits are available for an additional $22 per month. Plan Star rating is 4.5.

MedMutual Advantage Premium – $128 per month premium and $55 deductible. PPO with $3,450 maximum out-of-pocket expenses. Inpatient hospital copay is $375 for the first 6 days. Outpatient hospital copay is $380. Pcp and specialist office visit copays are $0 and $30. Urgent Care and ER copays are $30 and $120. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $30. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 32% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Comprehensive dental benefits are included, subject to policy limitations. Plan Star rating is 4.5.

MedMutual Advantage Secure – $20 per month premium and $95 deductible. HMO with $3,500 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 6 days. Outpatient hospital copay is $335. Pcp and specialist office visit copays are $0 and $20. Urgent Care and ER copays are $20 and $90. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $50 copay. Outpatient individual and group mental health therapy visits are $20. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and 31% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $38 (Tier 2 generic), $118 (Tier 3 preferred generic), 50% (Tier 4 non-preferred), and n/a (Tier 5 specialty).  Comprehensive dental benefits are included, subject to policy limitations. Plan Star rating is 4.0.

Paramount Elite Choice Medical And Drug – $21 per month premium and $0 deductible. HMO with $4,000 maximum out-of-pocket expenses. Inpatient hospital copay is $225 for the first 5 days. Outpatient hospital copay is $200. Pcp and specialist office visit copays are $0 and $35. Urgent Care and ER copays are $35 and $90. Lab services are subject to a $0-$15 copay, and outpatient x-rays are subject to a $25 copay. Outpatient individual and group mental health therapy visits are $35. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $45 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $30 (Tier 2 generic), $135 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits are available for an additional $28.20 per month. Plan Star rating is 4.0.

Paramount Elite Essential Medical And Drug – $200 per month premium and $0 deductible. HMO with $4,900 maximum out-of-pocket expenses. Inpatient hospital copay is $300 for the first 5 days. Outpatient hospital copay is $275. Pcp and specialist office visit copays are $5 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $20 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $20 (Tier 2 generic), $45 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $30 (Tier 2 generic), $135 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental benefits are available for an additional $28.20 per month. Plan Star rating is 4.0.

Prime Time Health Plan Aultimate – $0 per month premium and $200 deductible. HMO-POS with $4,500 maximum out-of-pocket expenses. Inpatient hospital copay is $290 for the first 6 days. Outpatient hospital copay is $350. Pcp and specialist office visit copays are $5 and $45. Urgent Care and ER copays are $65 and $90. Lab services are subject to a $35 copay, and outpatient x-rays are subject to a $100 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $15 (Tier 2 generic), $42 (Tier 3 preferred generic), $95 (Tier 4 non-preferred), and 29% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $45 (Tier 2 generic), $126 (Tier 3 preferred generic), $285 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Plan Star rating is 4.5.

Prime Time Health Plan Basic – MA Only – $0 per month premium.  HMO-POS with $3,400 maximum out-of-pocket expenses. Inpatient hospital copay is $275 for the first 6 days. Outpatient hospital copay is 25%. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $65 and $85. Lab services are subject to a $35 copay, and outpatient x-rays are subject to a $100 copay. Outpatient individual and group mental health therapy visits are $35. Prescription coverage is not included.

SummaCare Medicare Topaz – $0 per month premium and $150 deductible. Local HMO with $3,800 maximum out-of-pocket expenses. Inpatient hospital copay is $295 for the first 5 days. Outpatient hospital copay is $300. Pcp and specialist office visit copays are $0 and $45. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0-$10 copay, and outpatient x-rays are subject to a $75-$130 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 30% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $117.50 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $25 per month. Plan Star rating is 4.5.

SummaCare Medicare Ruby – $43 per month premium and $0 deductible. Local HMO with $3,600 maximum out-of-pocket expenses. Inpatient hospital copay is $275 for the first 6 days. Outpatient hospital copay is $250. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0-$8 copay, and outpatient x-rays are subject to a $0-$125 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $117.50 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $25 per month. Plan Star rating is 4.5.

SummaCare Medicare Sapphire – $76 per month premium and $0 deductible. Local HMO with $3,600 maximum out-of-pocket expenses. Inpatient hospital copay is $275 for the first 6 days. Outpatient hospital copay is $250. Pcp and specialist office visit copays are $0 and $40. Urgent Care and ER copays are $40 and $90. Lab services are subject to a $0-$8 copay, and outpatient x-rays are subject to a $0-$99 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $0 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 33% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $25 (Tier 2 generic), $117.50 (Tier 3 preferred generic), $300 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is offered for an additional $25 per month.

The Health Plan SecureCare Option IV – $0 per month premium and $200 deductible. Local HMO with $4,200 maximum out-of-pocket expenses. Inpatient hospital copay is $325 for the first 5 days. Outpatient hospital copay is $0-$275. Pcp and specialist office visit copays are $15 and $45. Urgent Care and ER copays are $65 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $75 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $5 (Tier 1 preferred generic), $10 (Tier 2 generic), $35 (Tier 3 preferred generic), $85 (Tier 4 non-preferred), and 29% (Tier 5 specialty). 90-Day prescription drug copays are $15 (Tier 1 preferred generic), $30 (Tier 2 generic), $105 (Tier 3 preferred generic), $255 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is not available. Plan Star rating is 3.5.

The Health Plan SecureCare Option Il – $64 per month premium and $100 deductible. Local HMO with $6,700 maximum out-of-pocket expenses. Inpatient hospital copay is $250 for the first 5 days. Outpatient hospital copay is $0-$250. Pcp and specialist office visit copays are $10 and $45. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $0-$50 copay. Outpatient individual and group mental health therapy visits are $40. 30-Day prescription drug copays are $3 (Tier 1 preferred generic), $10 (Tier 2 generic), $47 (Tier 3 preferred generic), $100 (Tier 4 non-preferred), and 31% (Tier 5 specialty). 90-Day prescription drug copays are $0 (Tier 1 preferred generic), $0 (Tier 2 generic), $94 (Tier 3 preferred generic), $200 (Tier 4 non-preferred), and n/a (Tier 5 specialty). Comprehensive dental coverage is not available. Plan Star rating is 3.5.

The Health Plan SecureCare Option I MA Only – $0 per month premium. Local HMO with $3,900 maximum out-of-pocket expenses. Inpatient hospital copay is $250 for the first 5 days. Outpatient hospital copay is $0-$250. Pcp and specialist office visit copays are $5 and $45. Urgent Care and ER copays are $45 and $90. Lab services are subject to a $0 copay, and outpatient x-rays are subject to a $0-$50 copay. Outpatient individual and group mental health therapy visits are $40. Prescription coverage is not included. Comprehensive dental coverage is available for an additional $23 per month. Plan Star rating is 3.5.

Medicare Advantage in Ohio for Diabetes is also offered. The Humana Gold Plus – Diabetes And Heart (HMO C-SNP) plan is widely available  with a monthly premium of $15. the deductible is $200, and the preferred generic, generic, and preferred brand drug copays are $7, $17, and $47. The primary and specialist office visit copays are $10 and $45. The lab services copay is $0-$35 and outpatient x-rays are subject to $10-$110 copays. Occupational therapy is subject to $10-$40 copays.

Several Medicare consumer publications are available for Ohio residents. The shoppers guide explains how supplemental plans work with Parts A and B benefits. Although it is not a legal document, regulations, rulings, and legal guidance is provided. The publication includes sections on buying, patient rights, persons with a disability or ESRD, and definitions. Upon request, we will email the latest edition.