Medicare Advantage Plans for Gaston County, North Carolina

  • 55 Total Plans
  • 46,677 Seniors Eligible for Medicare
  • 25,624 Seniors on Medicare Advantage (55%)
  • 7 plans with 1,850 seniors have enough OTC benefit to fully cover MDHearing hearing aids
  • 31 plans with 18,787 seniors have OTC benefits that partially cover MDHearing hearing aids
  • 44% of seniors can partially or fully cover OTC hearing aids from MDHearing (if their plan has MDHearing hearing aids)
OTC Supplemental Benefits Prescription Hearing Aid Coverage
Company Plan name Plan type OTC Supplement OTC Rolls Over? Annual OTC Supplement Coverage? Covered Amount Covers OTC Aids? Coinsurance? Copay? Prior Authorization? Need Referral? North Carolina Enrollees
Humana Humana Gold Plus H1036-137 (HMO-POS)
H1036-137-0 		HMOPOS $50 per Quarter No $200 Yes No No Yes No No 4,508
Aetna Medicare Aetna Medicare Premier Plan (PPO)
H5521-081-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 3,136
Humana Humana Medicare Employer (PPO)
H5216-805-0 		Local PPO No $0 No 2,761
UnitedHealthcare AARP Medicare Advantage Plan 2 (HMO-POS)
H5253-038-0 		HMOPOS $50 per Quarter No $200 Yes Yes No Yes Yes No 2,198
UnitedHealthcare AARP Medicare Advantage Plan 1 (HMO-POS)
H5253-037-0 		HMOPOS $60 per Quarter No $240 Yes Yes No Yes Yes No 2,029
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3146-001-0 		HMOPOS $90 per Quarter No $360 Yes $2,500 No No Yes No No 1,687
Humana Humana Gold Plus SNP-DE H1036-167 (HMO-POS D-SNP)
H1036-167-0 		HMOPOS $3,900 per Month Yes $0 Yes No No Yes Yes No 975
Cigna Healthcare Cigna Preferred Medicare (HMO)
H9725-009-4 		HMO $75 per Quarter No $300 Yes No No Yes No No 881
Blue Cross Blue Shield of Michigan Medicare Plus Blue PPO Employer CY (PPO)
H9572-802-0 		Local PPO No $0 No 756
Blue Cross and Blue Shield of North Carolina Blue Medicare Essential Plus (HMO-POS)
H3449-023-5 		HMOPOS $95 per Quarter No $380 Yes No No Yes No No 691
UnitedHealthcare UnitedHealthcare Dual Complete (HMO-POS D-SNP)
H5253-041-0 		HMOPOS $326 per Month No $0 Yes $2,500 Yes No Yes Yes No 634
Blue Cross and Blue Shield of North Carolina Blue Medicare Enhanced (HMO-POS)
H3449-024-3 		HMOPOS $95 per Quarter No $380 Yes No No Yes No No 602
Aetna Medicare Aetna Medicare Value Plus Plan (HMO)
H3146-006-0 		HMO $105 per Quarter No $420 Yes $2,500 No No Yes No No 452
Cigna Healthcare Cigna Preferred Plus Medicare (HMO)
H9725-006-0 		HMO $40 per Quarter No $160 Yes No No Yes No No 371
Blue Cross and Blue Shield of North Carolina Blue Medicare PPO Enhanced (PPO)
H3404-003-2 		Local PPO $90 per Quarter No $360 Yes No No Yes No No 314
UnitedHealthcare AARP Medicare Advantage Patriot (HMO-POS)
H5253-040-0 		HMOPOS $40 per Quarter No $160 Yes Yes No Yes Yes No 308
Humana HumanaChoice H5216-017 (PPO)
H5216-017-0 		Local PPO No $0 Yes No No Yes No No 249
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-008-0 		HMO $185 per Month Yes $0 Yes $5,000 No No Yes No No 222
Senior Total Life Care Senior Total Life Care Dual (PACE)
H4235-001-0 		National PACE No $0 No 185
Cigna Healthcare Cigna TotalCare (HMO D-SNP)
H9725-003-0 		HMO $200 per Quarter No $800 Yes No No Yes No No 166
Blue Cross and Blue Shield of North Carolina Blue Medicare Essential (HMO)
H3449-027-2 		HMO $0 per Month No $0 Yes No No Yes No No 164
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-837-0 		Local PPO No $0 No 151
Humana HumanaChoice H5216-211 (PPO)
H5216-211-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 147
UnitedHealthcare UnitedHealthcare Dual Complete Choice (PPO D-SNP)
H1889-005-0 		Local PPO $301 per Month No $0 Yes $2,500 Yes No Yes Yes No 139
Cigna Healthcare Cigna True Choice Medicare (PPO)
H7849-019-0 		Local PPO No $0 Yes $1,500 No No No No No 114
Aetna Medicare Aetna Medicare Plan (PPO)
H5521-801-0 		Local PPO No $0 No 108
Humana Humana Honor (Regional PPO)
R1390-003-0 		Regional PPO $75 per Quarter No $300 Yes No No Yes No No 108
Humana Humana Gold Choice H8145-004 (PFFS)
H8145-004-0 		PFFS $75 per Quarter No $300 Yes No No Yes No No 100
Blue Cross and Blue Shield of North Carolina Blue Medicare Medical Only (HMO-POS)
H3449-012-0 		HMOPOS $100 per Quarter No $400 Yes No No Yes No No 99
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-817-0 		Local PPO No $0 No 87
Wellcare Wellcare No Premium (HMO)
H4073-001-0 		HMO $107 per Quarter No $428 Yes $1,500 No No Yes Yes No 87
Humana HumanaChoice H5216-343 (PPO)
H5216-343-0 		Local PPO No $0 Yes No No Yes No No 84
UnitedHealthcare UnitedHealthcare Dual Complete Select (HMO-POS D-SNP)
H5253-116-0 		HMOPOS $72 per Month No $0 Yes $1,100 Yes No Yes Yes No 84
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-354-0 		Local PPO $75 per Quarter No $300 No 83
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-816-0 		Local PPO No $0 No 78
Wellcare Wellcare Giveback Open (PPO)
H7175-004-0 		Local PPO No $0 Yes $1,500 No No Yes Yes No 64
Aetna Medicare Aetna Medicare Eagle Plan (PPO)
H5521-241-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 59
Humana HumanaChoice R1390-001 (Regional PPO)
R1390-001-0 		Regional PPO $45 per Quarter No $180 Yes No No Yes No No 52
UnitedHealthcare UnitedHealthcare Nursing Home Plan (PPO I-SNP)
H0710-034-0 		Local PPO $350 per Quarter Yes $1,400 Yes $3,600 Yes No Yes Yes No 50
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-870-0 		Local PPO No $0 No 49
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H5521-802-0 		Local PPO No $0 No 46
Blue Cross and Blue Shield of North Carolina Healthy Blue + Medicare (HMO D-SNP)
H9147-001-0 		HMO $257 per Month No $0 Yes $3,000 Yes No Yes Yes No 45
Wellcare Wellcare Dual Liberty Open (PPO D-SNP)
H7175-002-0 		Local PPO $144 per Month Yes $0 Yes $3,000 No No Yes Yes No 40
Wellcare Wellcare No Premium Open (PPO)
H7175-001-0 		Local PPO $93 per Quarter No $372 Yes $1,000 No No Yes Yes No 35
Humana HumanaChoice R1390-002 (Regional PPO)
R1390-002-0 		Regional PPO $25 per Quarter No $100 Yes No No Yes No No 33
Humana Humana Gold Plus H6622-057 (HMO-POS)
H6622-057-0 		HMOPOS $50 per Quarter No $200 Yes No No Yes No No 33
Wellcare Wellcare Dual Access (HMO D-SNP)
H4073-002-0 		HMO $170 per Month Yes $0 Yes $5,000 No No Yes Yes No 31
UnitedHealthcare UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
H5253-042-0 		HMOPOS $240 per Quarter Yes $960 Yes $2,000 Yes No Yes Yes No 27
Highmark Blue Cross Blue Shield or Highmark Blue Shield Freedom Blue PPO MAPD PA CALENDAR (PPO)
H3916-802-0 		Local PPO No $0 No 24
Cigna Healthcare Cigna Courage Medicare (HMO)
H9725-005-0 		HMO No $0 Yes No No Yes No No 22
Wellcare Wellcare Assist Open (PPO)
H7175-003-0 		Local PPO $125 per Quarter No $500 Yes $2,000 No No Yes Yes No 22
Humana HumanaChoice SNP-DE H5525-036 (PPO D-SNP)
H5525-036-0 		Local PPO $3,000 per Month No $0 Yes No No Yes No No 13
Aetna Medicare Aetna Medicare Plan w/Rx $75 Buy-Down (PPO)
H5521-812-0 		Local PPO No $0 No 12
UnitedHealthcare UnitedHealthcare Assisted Living Plan (HMO-POS I-SNP)
H5253-043-0 		HMOPOS $145 per Quarter Yes $580 Yes $2,000 Yes No Yes Yes No 12
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-847-0 		Local PPO No $0 No 11
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