Medicare advantage hmo ppo plans in san juan puerto rico


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2006 Medicare Advantage COSTSHARE REPORTSM

San Juan PR Area Comparisons

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*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	Preferred Medicare Choice (San Juan Care Gold) **	$0 [Tie]	Preferred Medicare Choice (San Juan Care Gold)**	$0	Preferred Medicare Choice (Auxillo Platino) **	$1,010
#2	Salud Dorada Con Medicare (Medicare Excel) **	$0 [Tie]	Medicare y Mucho Mas (Basico) **	$277	Preferred Medicare Choice (San Juan Care Gold)**	$1,312
#3	Preferred Medicare Choice (Auxillo Platino) **	$95	Preferred Medicare Choice (Auxillo Platino) **	$355	Medicare y Mucho Mas (Basico) **	$1,793
#4	Medicare y Mucho Mas (Basico) **	$102	Humana (Gold Plus) **	$580	Salud Dorada Con Medicare ( Medicare Prime)	$1,832
#5	Humana (Gold Plus) **	$120	Salud Dorada Con Medicare ( Medicare Excel) **	$599	Salud Dorada Con Medicare ( Medicare Excel) **	$1,839
#6	Mapre Life (Medicare Excel Premier)	$500	Mapre Life ( Medicare Excel Premier)	$605	Mapre Life ( Medicare Excel Premier)	$2,028
#7	Mapre Life ( Medicare Excel Extended) **	$541	MSC Classicare (Premium A) **	$765	Cosvimed-Care (Cosvimed Care RmaX)	$2,305
#8	MSC Classicare (Premium A) **	$560	MSC Classicare (Premium B)	$902	MSC Classicare (Premium A) **	$2,320
#9	Cosvimed-Care (Cosvimed Care)	$659	American Health Medicare (Basic Plus $32)	$924	MSC Classicare (Premium B)	$2,372
#10	Cosvimed-Care (Cosvimed Care RmaX)	$688	Cosvimed-Care (Cosvimed Care RmaX)	$1,030	Humana (Gold Plus) **	$2,458
#11	American Health Medicare (Basic Plus $32)	$694	Humana (Gold Choice PFFS)	$1,078	American Health Medicare (Basic Plus $32)	$2,504
#12	MSC Classicare (Premium B)	$762	Salud Dorada Con Medicare ( Medicare Prime)	$1,107	American Health Medicare (Basic Plus $98)	$2,744
#13	Humana (Gold Choice PFFS)	$773	Cosvimed-Care (Cosvimed Care)	$1,112	Humana (Gold Choice PFFS)	$2,785
#14	Salud Dorada Con Medicare ( Medicare Prime)	$832	Mapre Life ( Medicare Excel Extended) **	$1,614	Cosvimed-Care (Cosvimed Care)	$2,976
#15	American Health Medicare (Basic Plus $98)	$1,491	American Health Medicare (Basic Plus $98)	$1,691	Mapre Life ( Medicare Excel Extended) **	$3,107

	Average:All Plans	$521	Average:All Plans	$843	Average:All Plans	$2,226

*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.

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** "Zero premium" plans.

PFFS = Private-fee-for-service

COSTSHARE REPORT is a registered mark of HealthMetrix Research Inc.

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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.

To request free information for selected Medicare Plans [click here]

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