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2006 Medicare
Advantage COSTSHARE REPORTSM
Fairfax Area Comparisons
Estimated Annual Cost-Sharing* by Medicare Advantage Plan & Health Status
All Plans below
include Medicare Part D-Drug Benefits |
RANK |
HEALTH
STATUS: GOOD
See utilization details below
|
HEALTH
STATUS: FAIR
See utilization details below
|
HEALTH
STATUS: POOR
See utilization details below
|
#1 |
Humana
(Gold Choice PFFS) ** |
$380
|
Humana
(Gold Choice PFFS) ** |
$1,690
|
Aetna Health
(Golden Medicare Premier) |
$3,619 |
#2 |
Aetna
Health (Golden Medicare Standard) |
$716 |
Aetna Health
(Golden Medicare Premier) |
$1,839 |
Kaiser
Permanente (Medicare Plus - $79) |
$4,080 |
#3 |
Kaiser
Permanente (Medicare Plus - $49) |
$943 |
Aetna Health
(Golden Medicare Standard) |
$2,009 |
Humana
(Gold Choice PFFS) ** |
$5,153
|
#4 |
Kaiser
Permanente (Medicare Plus - $79) |
$1,233 |
Kaiser
Permanente (Medicare Plus - $79) |
$2,098 |
Aetna Health
(Golden Medicare Standard) |
$5,161 |
#5 |
Aetna Health
(Golden Medicare Premier) |
$1,236 |
Kaiser
Permanente (Medicare Plus - $49) |
$2,153 |
Kaiser
Permanente (Medicare Plus - $49) |
$5,260 |
| |
|
|
|
|
|
|
| |
Average:All
Plans |
$902 |
Average:All
Plans |
$1,970 |
Average:All
Plans |
$4,655 |
*Annual cost (out-of-pocket expenses) include applicable copayments,
deductibles, and premiums. Premiums
may vary depending on county of residence. Medicare Part B premium ($88.50 per month in 2006) is not included in cost
calculations.
The information contained herein is neither guaranteed nor intended to
represent actual enrollee experiences for any Medicare plan. Benefits, copayments, deductibles, and premiums are subject to change. HealthMetrix Research Inc. does not endorse or recommend specific
Medicare plans.
Senior Choice Gold Award recipient
for "Excellence in Medicare Benefits Value"
** "Zero
premium" plans.
PFFS
= Private-fee-for-service
COSTSHARE REPORT is
a registered mark of HealthMetrix Research Inc.
To
request free information for selected Medicare Plans [click here]
NOTE: The
above comparisons are based on the annual utilization assumptions below:
Health
Status: GOOD
Requiring periodic
routine care |
Health
Status: FAIR
Requiring episodic
care for non-chronic conditions |
Health
Status: POOR
Requiring chronic
disease care and
management |
| Low
annual utilization
- 4 Doctor office visits (in-network)
- 1 Urgent care visit (out-of-area)
- 0 Inpatient admissions
- 6 Prescriptions (30 day supply)
- 1 Physical, vision, hearing exam
- 1 Dental prevention visit |
Moderate
annual utilization
- 12 Doctor office visits (in-network)
- 1 Emergency room visit
- 1 Inpatient admission (4
days)
- 24 Prescriptions (2 per month)
- 1 Physical, vision, hearing exam
- 1 Dental prevention visit |
High
annual utilization
- 24 Doctor office visits (in-network)
- 2 Emergency room visits
- 3 Inpatient admissions (12
days)
- 72 Prescriptions (6 per month)
- 1 Physical, vision, hearing exam
- 1 Dental prevention visit |
Vision exam
average cost of $50 is included if not a covered benefit.
Hearing exam average cost of $50 is included if not a covered benefit.
Dental prevention visit average cost of $75 is included if not a covered
benefit.
Prescriptions based on $42 average charge for up to a 30-day generic prescription ($84 for 90-day supply); $75 average charge for up to a 30-day brand prescription ($150 for 90-day supply); 1:1 brand-to-generic prescription
ratio; includes available 90-day supply by mail; no injectables; other
applicable prescription discounts are not included; other additional
restrictions including, but not limited to, approved drug formularies, quarterly
prescription limits, or prescription cost formulas may affect annual
cost-sharing.
©1999 - 2006 HealthMetrix Research Inc. Columbus, OH All
Rights Reserved.
To
request free information for selected Medicare Plans [click here]
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