Newton County, Texas Medicare Companies and Plans (2022)

Eligible residents can buy Newton County Medicare plans from multiple insurance companies. Medicare plans available in Newton County include Medicare Advantage (Part C), Part D prescription drug coverage, and Medicare Supplement (Medigap) plans. The best way to choose the right Medicare coverage in Newton County, TX is to compare coverage and rates from multiple companies.

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The Highlights

  • Medicare supplement plans in Newton County are designed to cover out-of-pocket costs not paid for by original Medicare
  • Medicare supplement plans in Newton County, TX include Medigap Plan F and Medigap Plan N
  • Medicare Advantage plans in Newton County, Texas may include dental, vision, and hearing coverage

Newton County, Texas Medicare plans are widely available, and Medicare-eligible residents can compare options that include Medicare Advantage, standalone Medicare Part D, and Medicare Supplement plans to fill the gaps in original Medicare.

Whether you are just looking for Medigap coverage in Newton County to avoid out-of-pocket costs not covered by your Medicare Part A and B or want to sign up for Medicare Advantage instead, comparing your options is the best way to find affordable Newton County, TX Medicare coverage that suits your needs.

Ready to find cheap Medicare rates in Newton County, TX? Enter your ZIP code to compare Newton County, Texas Medicare plans today.

Medicare Advantage Companies in Newton County, Texas

A Medicare Advantage plan in Newton County, TX can provide additional coverage above and beyond original Medicare and allows you to choose your plan, coverage, and network. Take a look at the companies that offer Medicare Advantage plans in Newton County, Texas.

Medicare Advantage Companies in Newton County, Texas

Plan Name Monthly Prem. (Parts C & D) Deductible Additional Gap Coverage Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
Cigna Fundamental Medicare (HMO) – H4513-009-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $3,900
Cigna Preferred Medicare (HMO) – H4513-061-1 $0.00 $190 . Tier 1, 2 and 3 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $42.00, Non-Preferred Drug: $95.00, Specialty Tier: 29% $4,300
Cigna TotalCare (HMO D-SNP) – H4513-060-1 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: 15%, Tier 2: 15%, Tier 3: 15%, Tier 4: 15%, Tier 5: 15% n/a
Community Health Choice (HMO D-SNP) – H9826-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00 n/a
HumanaChoice R4182-001 (Regional PPO) – R4182-001-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $5,700
HumanaChoice R4182-003 (Regional PPO) – R4182-003-0 $93.00 $175 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $7.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $99.00, Specialty Tier: 30% $7,200
HumanaChoice R4182-004 (Regional PPO) – R4182-004-0 $55.00 $175 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $6.00, Generic: $13.00, Preferred Brand: $47.00, Non-Preferred Drug: $99.00, Specialty Tier: 30% $7,200
Lasso Healthcare Growth (MSA) – H1924-001-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
Lasso Healthcare Growth Plus (MSA) – H1924-004-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) – R6801-011-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a
UnitedHealthcare Medicare Advantage Choice (Regional PPO) – R6801-012-0 $49.00 $395 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 25% $7,550
UnitedHealthcare Medicare Gold (Regional PPO C-SNP) – R6801-009-0 $29.00 $295 . Tier 1, 2 and 3 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% n/a
UnitedHealthcare Medicare Silver (Regional PPO C-SNP) – R6801-008-0 $4.90 $445 No additional gap coverage, only the Donut Hole Discount Tier 1: 25%, Tier 2: 25%, Tier 3: 25%, Tier 4: 25%, Tier 5: 25% n/a
WellCare Access (HMO D-SNP) – H0174-004-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% n/a
WellCare Compass (HMO) – H0174-009-0 $16.20 $445 . Tier 1 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% $3,450
WellCare Dividend Prime (HMO) – H0174-007-0 $0.00 $300 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $30.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $6,700
WellCare Liberty (HMO D-SNP) – H0174-006-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $20.00, Preferred Brand: $47.00, Non-Preferred Drug: 50%, Specialty Tier: 25% n/a
WellCare Value (HMO-POS) – H0174-005-0 $0.00 $0 Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $30.00, Non-Preferred Drug: $85.00, Specialty Tier: 33% $4,500

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Medicare Supplement Companies in Newton County, Texas

If you choose original Medicare in Newton County, TX, you can get coverage for out-of-pocket costs like deductibles, co-pays, and coinsurance with a Newton County Medicare Supplement plan. Take a look at which companies offer Medicare Supplement plans in Newton County, TX and which plans are available.

Medicare Supplement Companies in Newton County, Texas

Company Plans
AARP – UnitedHealthcare Insurance Company (Level 1) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 1/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 2) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Level 2/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Standard) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
AARP – UnitedHealthcare Insurance Company (Standard/Household) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Accendo Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Aetna Health Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
American Benefit Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
American Financial Security Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Amerigroup (an Anthem Company) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Atlantic Coast Life Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Atlantic Coast Life Insurance Company (Household) Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Bankers Fidelity Assurance Company (Preferred) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Bankers Fidelity Assurance Company (Standard) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
BlueCross BlueShield of Texas Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Capitol Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Catholic Life Insurance Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Central States Health and Life Co. of Omaha Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Cigna Health & Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Colonial Penn Life Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
Colonial Penn Life Insurance Company (Substandard) Medigap Plan A,
Medigap Plan B,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
Elips Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Federal Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
GPM Health and Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Garden State Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan M,
Medigap Plan N
Globe Life and Accident Insurance Company (Direct to Consumer) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Great Southern Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Great Southern Life Insurance Company (Class 1) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Guarantee Trust Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Heartland National Life Insurance Company Medigap Plan A,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan M,
Medigap Plan N
Humana Achieve (CompBenefits Insurance Company) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Humana Achieve (CompBenefits Insurance Company) (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Independence American Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Magna Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Manhattan Life Assurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Medico Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Nassau Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
National Guardian Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
National Health Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
National Health Insurance Company (Household) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan N
Old Surety Life Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G
Omaha Supplemental Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Oxford Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Pan-American Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Pekin Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Philadelphia American Life Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan M,
Medigap Plan N
Physicians Life Insurance Company (Issue Age) Medigap Plan A,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G
Prosperity Life Group (Preferred) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Prosperity Life Group (Standard) Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Puritan Life Insurance Company of America Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Resource Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G
Sentinel Security Life Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Shenandoah Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Southern Guaranty Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
State Farm Mutual Automobile Insurance Company Medigap Plan A,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Transamerica Life Insurance Company (Direct) Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan M,
Medigap Plan N
USAA Life Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
Union Security Insurance Company Medigap Plan A,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
United American Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
United Commercial Travelers of America Medigap Plan A,
Medigap Plan B,
Medigap Plan C,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
United Insurance Company of America Medigap Plan A,
Medigap Plan D,
Medigap Plan F,
Medigap Plan G,
Medigap Plan N
United States Fire Insurance Company Medigap Plan A,
Medigap Plan B,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Wisconsin Physicians Service Insurance Corporation Medigap Plan A,
Medigap Plan C,
Medigap Plan F,
Medigap Plan G,
Medigap Plan K,
Medigap Plan L,
Medigap Plan N
Physicians Life Insurance Company (Attained Age) Medigap Plan F,
Medigap Plan F-high deductible,
Medigap Plan G

Newton County, Texas Medicare Supplement Coverage by Plan

Not sure which Newton County Medicare supplement plan is right for you? Take a look at the details of each of the standard Texas Medicare supplement plans to find out what’s covered.

Newton County, Texas Medicare Supplement Coverage by Plan

Plan Name Monthly Cost Copays Coinsurance Deductibles Plan Benefits
Medigap Plan A Premiums range from $94-$1,616 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $1,484 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: No
Part A deductible: No
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan B Premiums range from $112-$711 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: No
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan C Premiums range from $129-$701 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan D Premiums range from $122-$600 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan F Premiums range from $112-$903 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan F-high deductible Premiums range from $32-$347 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services after you pay $2,370 deductible $2,370 total plan deductible.
After, you pay: $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan G Premiums range from $95-$924 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan G-high deductible Premiums range from $32-$180 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services after you pay $2,370 deductible $2,370 total plan deductible.
After, you pay: $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Plan K Premiums range from $48-$316 depending on your age, sex, health status, and when you buy. 10% Generally your cost for approved Part B services up to $6,220. Then, you’ll pay $0 for the rest of the year. $742 (50% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan L Premiums range from $68-$633 depending on your age, sex, health status, and when you buy. 5% Generally your cost for approved Part B services up to $3,110. Then, you’ll pay $0 for the rest of the year. $371 (25% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Plan M Premiums range from $77-$735 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $742 (50% of Part A deductible) Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes
Medigap Plan N Premiums range from $74-$656 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services with some $20 and $50 copays $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: Yes

Standalone Medicare Part D Plans in Newton County, Texas

If you’re looking to buy a standalone Newton County, TX Medicare Part D plan for prescription drug coverage, you have several options. Review the companies that offer Part D as a standalone policy and what sort of Medicare prescription coverage is available in Newton County, Texas.

Standalone Medicare Part D plans in Newton County, Texas

Plan Details Tiers
SilverScript SmartRx (PDP)
S5601 – 197 – 0
by Aetna Medicare
Monthly Premium: $7.30
Annual Deductable: $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: 48%
Tier 5: 25%
Clear Spring Health Premier Rx (PDP)
S6946 – 048 – 0
by Clear Spring Health
Monthly Premium: $13.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $40.00
Tier 4: 42%
Tier 5: 25%
Elixir RxPlus (PDP)
S7694 – 135 – 0
by Elixir Insurance
Monthly Premium: $15.10
Annual Deductable: $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%
WellCare Value Script (PDP)
S4802 – 155 – 0
by WellCare
Monthly Premium: $15.30
Annual Deductable: $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: $43.00
Tier 4: 49%
Tier 5: 25%
Express Scripts Medicare – Value (PDP)
S5660 – 124 – 0
by Express Scripts Medicare
Monthly Premium: $16.80
Annual Deductable: $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: $42.00
Tier 4: 50%
Tier 5: 25%
Humana Walmart Value Rx Plan (PDP)
S5884 – 201 – 0
by Humana
Monthly Premium: $17.20
Annual Deductable: $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: 18%
Tier 4: 35%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 191 – 0
by WellCare
Monthly Premium: $17.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $4.00
Tier 3: $40.00
Tier 4: 46%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 044 – 0
by Aetna Medicare
Monthly Premium: $18.10
Annual Deductable: $405
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: 40%
Tier 5: 25%
WellCare Classic (PDP)
S4802 – 013 – 0
by WellCare
Monthly Premium: $19.50
Annual Deductable: $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: $35.00
Tier 4: 35%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 143 – 0
by Humana
Monthly Premium: $19.70
Annual Deductable: $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: 34%
Tier 5: 25%
Clear Spring Health Value Rx (PDP)
S6946 – 019 – 0
by Clear Spring Health
Monthly Premium: $19.80
Annual Deductable: $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: $42.00
Tier 4: 33%
Tier 5: 25%
Elixir RxSecure (PDP)
S7694 – 022 – 0
by Elixir Insurance
Monthly Premium: $20.20
Annual Deductable: $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: 33%
Tier 5: 25%
Cigna Secure Rx (PDP)
S5617 – 108 – 0
by Cigna
Monthly Premium: $20.30
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $2.00
Tier 3: $45.00
Tier 4: 50%
Tier 5: 25%
Exemplar Health Basic (PDP)
S9325 – 004 – 0
by Exemplar Health
Monthly Premium: $21.40
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $3.00
Tier 2: $6.00
Tier 3: $47.00
Tier 4: 47%
Tier 5: 25%
Mutual of Omaha Rx Premier (PDP)
S7126 – 091 – 0
by Mutual of Omaha Rx
Monthly Premium: $23.60
Annual Deductable: $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%
Cigna Secure-Essential Rx (PDP)
S5617 – 301 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductable: $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: 48%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 293 – 0
by WellCare
Monthly Premium: $27.40
Annual Deductable: $415
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%
Express Scripts Medicare – Saver (PDP)
S5660 – 238 – 0
by Express Scripts Medicare
Monthly Premium: $27.50
Annual Deductable: $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%
Amerivantage Rx Enhanced (PDP)
S8182 – 002 – 0
by Amerigroup
Monthly Premium: $29.00
Annual Deductable: $340
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 40%
Tier 5: 26%
WellCare Medicare Rx Saver (PDP)
S5810 – 056 – 0
by WellCare
Monthly Premium: $31.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $4.00
Tier 3: $38.00
Tier 4: 41%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 403 – 0
by UnitedHealthcare
Monthly Premium: $31.90
Annual Deductable: $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%
AARP MedicareRx Saver Plus (PDP)
S5921 – 367 – 0
by UnitedHealthcare
Monthly Premium: $44.30
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $8.00
Tier 3: $38.00
Tier 4: 40%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 267 – 0
by Cigna
Monthly Premium: $45.70
Annual Deductable: $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%
Amerivantage Rx Basic (PDP)
S8182 – 001 – 0
by Amerigroup
Monthly Premium: $48.40
Annual Deductable: $410
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $2.00
Tier 3: $36.00
Tier 4: 33%
Tier 5: 25%
Blue Cross MedicareRx Basic (PDP)
S5715 – 014 – 0
by Blue Cross and Blue Shield of Texas
Monthly Premium: $59.40
Annual Deductable: $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: 13%
Tier 4: 43%
Tier 5: 25%
Humana Premier Rx Plan (PDP)
S5884 – 168 – 0
by Humana
Monthly Premium: $65.90
Annual Deductable: $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%
SilverScript Plus (PDP)
S5601 – 045 – 0
by Aetna Medicare
Monthly Premium: $69.20
Annual Deductable: $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: 50%
Tier 5: 33%
Amerivantage Rx Plus (PDP)
S8182 – 005 – 0
by Amerigroup
Monthly Premium: $69.70
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $43.00
Tier 4: 45%
Tier 5: 33%
Exemplar Health Enhanced (PDP)
S9325 – 003 – 0
by Exemplar Health
Monthly Premium: $76.10
Annual Deductable: $150
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $42.00
Tier 4: 43%
Tier 5: 25%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 145 – 0
by WellCare
Monthly Premium: $76.70
Annual Deductable: $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: 46%
Tier 5: 33%
Express Scripts Medicare – Choice (PDP)
S5660 – 192 – 0
by Express Scripts Medicare
Monthly Premium: $82.10
Annual Deductable: $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%
Mutual of Omaha Rx Plus (PDP)
S7126 – 021 – 0
by Mutual of Omaha Rx
Monthly Premium: $83.80
Annual Deductable: $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: 36%
Tier 5: 25%
AARP MedicareRx Preferred (PDP)
S5820 – 021 – 0
by UnitedHealthcare
Monthly Premium: $85.10
Annual Deductable: $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%
Blue Cross MedicareRx Value (PDP)
S5715 – 005 – 0
by Blue Cross and Blue Shield of Texas
Monthly Premium: $86.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Blue Cross MedicareRx Plus (PDP)
S5715 – 006 – 0
by Blue Cross and Blue Shield of Texas
Monthly Premium: $154.70
Annual Deductable: $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: $30.00
Tier 4: 40%
Tier 5: 33%

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