Medicare Advantage Plans for Wake County, North Carolina

  • 90 Total Plans
  • 163,856 Seniors Eligible for Medicare
  • 78,342 Seniors on Medicare Advantage (48%)
  • 6 plans with 4,832 seniors have enough OTC benefit to fully cover MDHearing hearing aids
  • 43 plans with 36,939 seniors have OTC benefits that partially cover MDHearing hearing aids
  • 25% 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 Medicare Employer (PPO)
H5216-805-0 		Local PPO No $0 No 18,827
Humana Humana Gold Plus H1036-233 (HMO-POS)
H1036-233-0 		HMOPOS No $0 Yes No No Yes No No 7,081
UnitedHealthcare AARP Medicare Advantage Plan 2 (HMO-POS)
H5253-039-0 		HMOPOS $40 per Quarter No $160 Yes Yes No Yes Yes No 6,083
Aetna Medicare Aetna Medicare Essential Plan (PPO)
H5521-168-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 5,517
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 4,267
Aetna Medicare Aetna Medicare Value Plan (HMO-POS)
H3146-004-0 		HMOPOS $75 per Quarter No $300 Yes $2,500 No No Yes No No 4,162
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 3,998
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 3,263
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-837-0 		Local PPO No $0 No 3,189
UnitedHealthcare AARP Medicare Advantage Plan 3 (HMO-POS)
H5253-117-0 		HMOPOS $50 per Quarter No $200 Yes Yes No Yes Yes No 1,700
Experience Health Experience Health Medicare Advantage (HMO)
H3777-001-4 		HMO $145 per Quarter No $580 Yes No No Yes No No 1,673
UnitedHealthcare AARP Medicare Advantage Plan 1 (HMO-POS)
H5253-102-0 		HMOPOS $50 per Quarter No $200 Yes Yes No Yes Yes No 1,355
UnitedHealthcare AARP Medicare Advantage Choice (PPO)
H2577-017-0 		Local PPO $40 per Quarter No $160 Yes Yes No Yes Yes No 1,335
Humana HumanaChoice H5216-211 (PPO)
H5216-211-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 1,326
Aetna Medicare Aetna Medicare Plan (PPO)
H5521-801-0 		Local PPO No $0 No 1,167
Alignment Health Plan Alignment Health Platinum (HMO-POS)
H5296-003-0 		HMOPOS $115 per Quarter No $460 Yes $0 No No No No No 1,133
Humana Humana Gold Plus SNP-DE H1036-276 (HMO-POS D-SNP)
H1036-276-0 		HMOPOS No $0 Yes No No Yes No No 1,011
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-817-0 		Local PPO No $0 No 862
UnitedHealthcare AARP Medicare Advantage Patriot (HMO-POS)
H5253-040-0 		HMOPOS $40 per Quarter No $160 Yes Yes No Yes Yes No 665
Aetna Medicare Aetna Medicare Assure Plan (HMO D-SNP)
H3146-002-0 		HMO $165 per Month Yes $0 Yes $5,000 No No Yes No No 572
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-816-0 		Local PPO No $0 No 531
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-866-0 		Local PPO No $0 No 531
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 521
FirstMedicare Direct FirstMedicare Direct SmartHMO (HMO)
H6306-005-0 		HMO $75 per Quarter No $300 No 456
Aetna Medicare Aetna Medicare Plan w/Rx (PPO)
H5521-802-0 		Local PPO No $0 No 448
Humana HumanaChoice H5525-035 (PPO)
H5525-035-0 		Local PPO No $0 Yes No No Yes No No 444
Blue Cross and Blue Shield of North Carolina Blue Medicare Choice (HMO)
H3449-026-0 		HMO $85 per Quarter No $340 Yes No No Yes No No 424
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 345
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 301
Wellcare Wellcare No Premium (HMO)
H4073-001-0 		HMO $107 per Quarter No $428 Yes $1,500 No No Yes Yes No 294
Humana HumanaChoice H5525-065 (PPO)
H5525-065-0 		Local PPO No $0 Yes No No Yes No No 290
Humana Humana Honor (Regional PPO)
R1390-003-0 		Regional PPO $75 per Quarter No $300 Yes No No Yes No No 287
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 283
Wellcare Wellcare Giveback Open (PPO)
H7175-004-0 		Local PPO No $0 Yes $1,500 No No Yes Yes No 236
Humana HumanaChoice R1390-002 (Regional PPO)
R1390-002-0 		Regional PPO $25 per Quarter No $100 Yes No No Yes No No 197
Blue Cross Blue Shield of Michigan Medicare Plus Blue PPO Employer CY (PPO)
H9572-802-0 		Local PPO No $0 No 186
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 173
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 152
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 143
Humana HumanaChoice H5525-050 (PPO)
H5525-050-0 		Local PPO No $0 Yes No No Yes No No 141
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-847-0 		Local PPO No $0 No 130
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 111
Wellcare Wellcare No Premium Open (PPO)
H7175-001-0 		Local PPO $93 per Quarter No $372 Yes $1,000 No No Yes Yes No 103
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-870-0 		Local PPO No $0 No 101
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 98
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-869-0 		Local PPO No $0 No 97
Senior CommUnity Care of North Carolina Senior CommUnity Care of North Carolina (PACE)
H0839-001-0 		National PACE No $0 No 82
Anthem Blue Cross and Blue Shield Anthem Medicare Preferred (PPO)
H4036-801-0 		Local PPO No $0 No 79
Humana HumanaChoice R1390-001 (Regional PPO)
R1390-001-0 		Regional PPO $45 per Quarter No $180 Yes No No Yes No No 76
Cigna Healthcare Cigna Preferred Select Medicare (HMO)
H9725-014-0 		HMO $120 per Quarter No $480 Yes No No Yes No No 73
Aetna Medicare Aetna Medicare Plan w/Rx $75 Buy-Down (PPO)
H5521-812-0 		Local PPO No $0 No 67
Blue Cross and Blue Shield of North Carolina Blue Medicare Freedom+ (PPO)
H3404-004-0 		Local PPO $0 per Month No $0 No 67
Humana Humana Gold Plus H6622-060 (HMO-POS)
H6622-060-0 		HMOPOS No $0 Yes No No Yes No No 65
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 64
Wellcare Wellcare Dual Access (HMO D-SNP)
H4073-002-0 		HMO $170 per Month Yes $0 Yes $5,000 No No Yes Yes No 60
Alignment Health Plan Alignment Health Heart & Diabetes (HMO C-SNP)
H5296-005-0 		HMO $150 per Quarter No $600 Yes $0 No No No No No 59
Wellcare Wellcare Assist Open (PPO)
H7175-003-0 		Local PPO $125 per Quarter No $500 Yes $2,000 No No Yes Yes No 56
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 55
Cigna Healthcare Cigna Preferred Savings Medicare (HMO)
H9725-012-0 		HMO No $0 Yes No No Yes No No 51
Humana HumanaChoice H5525-049 (PPO)
H5525-049-0 		Local PPO $50 per Quarter No $200 Yes No No Yes No No 51
UnitedHealthcare AARP Medicare Advantage Rebate (HMO-POS)
H5253-110-0 		HMOPOS No $0 Yes Yes No Yes Yes No 48
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-857-0 		Local PPO No $0 No 43
Liberty Medicare Advantage Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
H6351-001-0 		HMO No $0 Yes $2,800 No No No Yes No 40
Cigna Healthcare Cigna Preferred Medicare (HMO)
H9725-009-4 		HMO $75 per Quarter No $300 Yes No No Yes No No 37
Anthem Blue Cross and Blue Shield Anthem Medicare Preferred (PPO)
H4036-802-0 		Local PPO No $0 No 36
Highmark Blue Cross Blue Shield or Highmark Blue Shield Freedom Blue PPO MAPD PA CALENDAR (PPO)
H3916-802-0 		Local PPO No $0 No 36
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 34
PruittHealth Premier PruittHealth Premier (HMO I-SNP)
H6345-001-0 		HMO $55 per Month No $0 Yes $2,500 No No No No No 34
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 31
Aetna Medicare Aetna Medicare Plan (HMO)
H3931-801-0 		HMO No $0 No 29
Cigna Healthcare Cigna True Choice Medicare (PPO)
H7849-046-0 		Local PPO No $0 Yes $2,000 No No No No No 29
Humana HumanaChoice H5216-336 (PPO)
H5216-336-0 		Local PPO $75 per Quarter No $300 Yes No No Yes No No 27
Alignment Health Plan Alignment Health AVA (PPO)
H7074-001-0 		Local PPO $50 per Quarter No $200 No 25
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-836-0 		Local PPO No $0 No 25
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-872-0 		Local PPO No $0 No 24
Alignment Health Plan Alignment Health NC Duals (HMO D-SNP)
H5296-004-0 		HMO $1,000 per Quarter No $4,000 Yes $0 No No No No No 23
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-169-0 		Local PPO $150 per Quarter No $600 Yes $2,500 No No Yes No No 21
Blue Cross Blue Shield of Michigan Medicare Plus Blue PPO Employer Rx CY (PPO)
H9572-801-0 		Local PPO No $0 No 20
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H1537-801-0 		Local PPO No $0 No 19
Wellcare Wellcare Patriot No Premium Open (PPO)
H7175-005-0 		Local PPO No $0 No 18
Excellus Health Plan, Inc Medicare Blue PPO Group (PPO)
H3335-811-0 		Local PPO No $0 No 16
Aetna Medicare Aetna Medicare Value Plan (PPO)
H5521-139-0 		Local PPO $45 per Quarter No $180 Yes $2,500 No No Yes No No 15
Cigna Cigna True Choice Medicare (PPO)
H7849-803-0 		Local PPO No $0 No 15
Aetna Medicare Aetna Medicare Premier Plus Plan (PPO)
H5521-170-0 		Local PPO $75 per Quarter No $300 Yes $2,500 No No Yes No No 14
Highmark Blue Cross Blue Shield or Highmark Blue Shield Freedom Blue PPO MA PA CALENDAR (PPO)
H3916-801-0 		Local PPO No $0 No 14
Blue Cross and Blue Shield of Montana Blue Cross Group Medicare Advantage (PPO)
H0107-803-0 		Local PPO No $0 No 12
UnitedHealthcare AARP Medicare Advantage Plan 2 (HMO-POS)
H5253-038-0 		HMOPOS $50 per Quarter No $200 Yes Yes No Yes Yes No 12
UnitedHealthcare UnitedHealthcare Group Medicare Advantage (PPO)
H2001-840-0 		Local PPO No $0 No 12
Blue Cross and Blue Shield of North Carolina Blue Medicare HMO EGWP Classic (HMO)
H3449-815-0 		HMO No $0 No 11
Cigna Cigna True Choice Core Medicare (PPO)
H7849-804-0 		Local PPO No $0 No 11
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