Medicare Plans Found For Part C With Drug Coverage

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,200.00

Drugs Covered

Drug Deductible:
$615.00

AARP Medicare Advantage from UHC IN-19 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$600.00

UHC Dual Complete KS-Q1 (HMO-POS D-SNP)

Plan Not Rated

2026

Dual-Eligible

Not Applicable

Premium:
$47.50

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

HumanaChoice H7617-050 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,250.00

Drugs Covered

Drug Deductible:
$350.00

Humana Gold Plus H5619-071 (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,450.00

Drugs Covered

Drug Deductible:
$250.00

Essence Advantage Choice (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$19.80

Health Plan Deductible:

MOOP:
$4,150.00

Drugs Covered

Drug Deductible:
$340.00

HumanaChoice H5216-317 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,250.00

Drugs Covered

Drug Deductible:
$350.00

HumanaChoice Giveback H5216-322 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$615.00

HumanaChoice Giveback H5216-226 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,600.00

Drugs Covered

Drug Deductible:
$615.00

DEVOTED CHOICE 008 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,900.00

Drugs Covered

Drug Deductible:
$0.00

DEVOTED CHOICE GIVEBACK 009 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$605.00

DEVOTED C-SNP CHOICE PREMIUM 017 IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$5,900.00

Drugs Covered

Drug Deductible:
$615.00

HumanaChoice Giveback H7617-049 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$615.00

CommuniCare Advantage ISNP (HMO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Humana Gold Choice H8145-032 (PFFS)

Plan Not Rated

2026

Not Applicable

Premium:
$37.00

Health Plan Deductible:

MOOP:
$3,950.00

Drugs Covered

Drug Deductible:
$300.00

HumanaChoice H5216-188 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$32.00

Health Plan Deductible:

MOOP:
$6,600.00

Drugs Covered

Drug Deductible:
$300.00

DEVOTED CHOICE GIVEBACK 012 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$605.00

DEVOTED C-SNP CHOICE PREMIUM 014 IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$5,100.00

Drugs Covered

Drug Deductible:
$615.00

Aetna Medicare Chronic Care Total (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

AARP Medicare Advantage from UHC IN-13 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,900.00

Drugs Covered

Drug Deductible:
$520.00

AARP Medicare Advantage from UHC IN-0009 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$520.00

AARP Medicare Advantage from UHC IN-0003 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$33.00

Health Plan Deductible:

MOOP:
$5,400.00

Drugs Covered

Drug Deductible:
$520.00

Essence Advantage (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,350.00

Drugs Covered

Drug Deductible:
$340.00

Anthem Medicare Advantage (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,000.00

Drugs Covered

Drug Deductible:
$150.00

Anthem Medicare Advantage (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,150.00

Drugs Covered

Drug Deductible:
$150.00

Zing Open Choice Diabetes & Heart IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,950.00

Drugs Covered

Drug Deductible:
$0.00

Zing Open Choice IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,350.00

Drugs Covered

Drug Deductible:
$0.00

Zing Select Care IN (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$0.00

Zing Select Diabetes & Heart IN (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$0.00

HumanaChoice H5525-008 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,550.00

Drugs Covered

Drug Deductible:
$220.00

Aetna Medicare Chronic Care Total (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Zing Select Dialysis IN (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

ChronicKidneyDisease

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,950.00

Drugs Covered

Drug Deductible:
$0.00

DEVOTED CHOICE 011 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,200.00

Drugs Covered

Drug Deductible:
$0.00

DEVOTED CHOICE GIVEBACK 006 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$605.00

DEVOTED CHOICE PREMIUM 007 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$10.30

Health Plan Deductible:

MOOP:
$5,900.00

Drugs Covered

Drug Deductible:
$615.00

DEVOTED C-SNP CHOICE PREMIUM 016 IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$6,200.00

Drugs Covered

Drug Deductible:
$615.00

Humana Gold Plus H5619-053 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,850.00

Drugs Covered

Drug Deductible:
$250.00

HumanaChoice H5216-229 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,200.00

Drugs Covered

Drug Deductible:
$250.00

HumanaChoice H5216-053 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$38.00

Health Plan Deductible:

MOOP:
$6,550.00

Drugs Covered

Drug Deductible:
$200.00

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,350.00

Drugs Covered

Drug Deductible:
$615.00

Anthem Medicare Advantage 2 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$100.00

Health Plan Deductible:

MOOP:
$6,850.00

Drugs Covered

Drug Deductible:
$300.00

Anthem Medicare Advantage 3 (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$54.00

Health Plan Deductible:

MOOP:
$5,150.00

Drugs Covered

Drug Deductible:
$300.00

DEVOTED CHOICE 005 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,800.00

Drugs Covered

Drug Deductible:
$0.00

AARP Medicare Advantage Essentials from UHC IN-12 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,900.00

Drugs Covered

Drug Deductible:
$440.00

AARP Medicare Advantage Extras from UHC IN-17 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$520.00

Humana Gold Plus H5619-049 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,250.00

Drugs Covered

Drug Deductible:
$250.00

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,900.00

Drugs Covered

Drug Deductible:
$615.00

Aetna Medicare Value Care (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$33.00

Health Plan Deductible:

MOOP:
$5,200.00

Drugs Covered

Drug Deductible:
$615.00

MyTruAdvantage Select (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,300.00

Drugs Covered

Drug Deductible:
$200.00

MyTruAdvantage Choice Complete (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$34.80

Health Plan Deductible:

MOOP:
$3,800.00

Drugs Covered

Drug Deductible:
$200.00

MyTruAdvantage Choice Plus (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,000.00

Drugs Covered

Drug Deductible:
$300.00

Aetna Medicare Signature (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,750.00

Drugs Covered

Drug Deductible:
$615.00

AARP Medicare Advantage from UHC IN-0007 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,900.00

Drugs Covered

Drug Deductible:
$600.00

AARP Medicare Advantage from UHC IN-0002 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$32.00

Health Plan Deductible:

MOOP:
$3,900.00

Drugs Covered

Drug Deductible:
$520.00

Provider Partners Indiana Advantage Plan (HMO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Provider Partners Indiana Community Plan (HMO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,750.00

Drugs Covered

Drug Deductible:
$615.00

Provider Partners Indiana Essential Plan (HMO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Anthem Medicare Advantage 2 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$26.00

Health Plan Deductible:

MOOP:
$6,750.00

Drugs Covered

Drug Deductible:
$250.00

American Health Advantage of Indiana (HMO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,000.00

Drugs Covered

Drug Deductible:
$615.00

Aetna Medicare Signature Extra (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,350.00

Drugs Covered

Drug Deductible:
$615.00

Aetna Medicare Value Care (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$36.00

Health Plan Deductible:

MOOP:
$6,750.00

Drugs Covered

Drug Deductible:
$615.00

UHC Nursing Home Plan IN-F001 (PPO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$24.60

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Anthem Medicare Advantage 3 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$55.00

Health Plan Deductible:

MOOP:
$6,750.00

Drugs Covered

Drug Deductible:
$150.00

HumanaChoice R0110-012 (Regional PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$20.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$350.00

HumanaChoice Giveback H7617-003 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$0.00

Humana USAA Honor Giveback with Rx (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$7,900.00

Drugs Covered

Drug Deductible:
$350.00

Anthem Medicare Advantage (Regional PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$97.00

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$45.00

AARP Medicare Advantage Essentials from UHC IN-10 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$3,900.00

Drugs Covered

Drug Deductible:
$440.00

Anthem Medicare Advantage (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,150.00

Drugs Covered

Drug Deductible:
$150.00

Wellcare Assist Open (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$5,000.00

Drugs Covered

Drug Deductible:
$380.00

Anthem Medicare Advantage (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$9.00

Health Plan Deductible:

MOOP:
$6,750.00

Drugs Covered

Drug Deductible:
$95.00

Anthem Medicare Advantage 3 (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$300.00

Anthem Medicare Advantage 4 (HMO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$300.00

DEVOTED CHOICE 001 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$0.00

DEVOTED CHOICE GIVEBACK 002 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$8,500.00

Drugs Covered

Drug Deductible:
$605.00

DEVOTED CHOICE PREMIUM 004 IN (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$11.40

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$615.00

DEVOTED C-SNP CHOICE PLUS 013 IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

DEVOTED C-SNP CHOICE PREMIUM 015 IN (PPO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$38.40

Health Plan Deductible:

MOOP:
$4,800.00

Drugs Covered

Drug Deductible:
$615.00

Humana Gold Plus H5619-051 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,500.00

Drugs Covered

Drug Deductible:
$250.00

HumanaChoice Giveback H5216-309 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$0.00

Humana Together in Health (PPO I-SNP)

Plan Not Rated

2026

Institutional

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

HumanaChoice H5216-463 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$28.00

Health Plan Deductible:

MOOP:
$6,350.00

Drugs Covered

Drug Deductible:
$400.00

Humana Gold Plus Chronic Kidney Disease (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

ChronicKidneyDisease

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,200.00

Drugs Covered

Drug Deductible:
$615.00

Wellcare Simple Open (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,300.00

Drugs Covered

Drug Deductible:
$615.00

Wellcare Giveback Open (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$8,500.00

Drugs Covered

Drug Deductible:
$615.00

Humana Gold Plus – Diabetes and Heart (HMO C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$0.00

Health Plan Deductible:

MOOP:
$9,150.00

Drugs Covered

Drug Deductible:
$615.00

AARP Medicare Advantage Essentials from UHC IN-11 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$5,900.00

Drugs Covered

Drug Deductible:
$520.00

AARP Medicare Advantage Extras from UHC IN-16 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$600.00

AARP Medicare Advantage Giveback from UHC IN-20 (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$600.00

UHC Complete Care IN-21 (HMO-POS C-SNP)

Plan Not Rated

2026

Chronic or Disabling Condition

CardiovascularDisorders,ChronicHeartFailure,DiabetesMellitus

Premium:
$0.00

Health Plan Deductible:

MOOP:
$6,700.00

Drugs Covered

Drug Deductible:
$440.00

AARP Medicare Advantage from UHC IN-0006 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,900.00

Drugs Covered

Drug Deductible:
$600.00

AARP Medicare Advantage from UHC IN-0001 (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$39.00

Health Plan Deductible:

MOOP:
$3,700.00

Drugs Covered

Drug Deductible:
$440.00

AARP Medicare Advantage from UHC IN-001P (PPO)

Plan Not Rated

2026

Not Applicable

Premium:
$0.00

Health Plan Deductible:

MOOP:
$4,200.00

Drugs Covered

Drug Deductible:
$440.00

UHC PathWays Dual Care IN-S1 (PPO D-SNP)

Plan Not Rated

2026

Dual-Eligible

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

UHC PathWays Dual Care IN-S3 (PPO D-SNP)

Plan Not Rated

2026

Dual-Eligible

Not Applicable

Premium:
$38.40

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Wellcare Assist (HMO-POS)

Plan Not Rated

2026

Not Applicable

Premium:
$31.10

Health Plan Deductible:

MOOP:
$5,700.00

Drugs Covered

Drug Deductible:
$560.00

Humana PathWays Dual Care (HMO-POS D-SNP)

Plan Not Rated

2026

Dual-Eligible

Not Applicable

Premium:
$20.90

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00

Humana Dual Select H4939-002 (HMO-POS D-SNP)

Plan Not Rated

2026

Dual-Eligible

Not Applicable

Premium:
$37.50

Health Plan Deductible:

MOOP:
$9,250.00

Drugs Covered

Drug Deductible:
$615.00