2024 Medicare Advantage & Other Plans - Colorado

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O
1	CY2024 Medicare Advantage, and Cost Plans
2	Data as of September 05, 2023. Includes CY2024 approved contracts/plans. PACE, Special Needs Plans, Part B Only Plans, and Employer sponsored plans (800 series) are excluded. Plans under sanction are not								shown. Medicare / Medicaid plans are shown in a separate file.
3	Notes: Data are subject to change as contracts are finalized. For CY2024, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the						formulary drugs, beyond the standard Part D benefit
4	* Indicates plan does not offer Part D drug coverage
5	** MOOP is defined as: Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. N/A is defin					ed as Not Applicable
6	State	County	Organization Name	Plan Name	Type of Medicare Health Plan	Monthly Consolidated Premium (Includes Part C + D)	Annual Drug Deductible	Drug Benefit Type	Drug Benefit Type Detail	Additional Coverage Offered in the Gap	Contract ID	Plan ID	Segment ID	In-network MOOP Amount **	Overall Star Rating
7	Colorado	Adams	Humana	Humana Gold Plus H0028-025 (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0028	025	1	$3,900
8	Colorado	Adams	Humana	Humana Gold Plus H0028-047 (HMO)	Local HMO	$24.00	$0.00	Enhanced	EA	No	H0028	047	0	$5,300
9	Colorado	Adams	Humana	Humana Gold Plus H0028-063 (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0028	063	0	$5,000
10	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0001 (HMO-POS)	Local HMO	$45.00	$0.00	Enhanced	EA	Yes	H0609	007	0	$2,900
11	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0002 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0609	012	0	$3,500
12	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage Patriot No Rx CO-MA01 (HMO-POS)	Local HMO *						H0609	018	0	$3,400
13	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0005 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0609	048	0	$3,800
14	Colorado	Adams	Kaiser Permanente	Kaiser Permanente Senior Advantage Core DM (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0630	013	0	$3,900
15	Colorado	Adams	Kaiser Permanente	Kaiser Permanente Senior Advantage Silver DM (HMO-POS)	Local HMO	$35.30	$0.00	Enhanced	EA	No	H0630	015	0	$3,400
16	Colorado	Adams	Kaiser Permanente	Kaiser Permanente Senior Advantage Gold (HMO-POS)	Local HMO	$181.00	$0.00	Enhanced	EA	No	H0630	016	0	$3,000
17	Colorado	Adams	Kaiser Permanente	Kaiser Permanente Senior Advantage Bronze DM (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0630	025	0	$4,100
18	Colorado	Adams	Cigna Healthcare	Cigna Preferred Medicare (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0672	001	0	$3,860
19	Colorado	Adams	Select Health	Select Health Medicare Essential (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	027	0	$3,900
20	Colorado	Adams	Select Health	Select Health Medicare + Kroger (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	030	0	$3,900
21	Colorado	Adams	Select Health	Select Health Medicare Flex (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	031	0	$3,900
22	Colorado	Adams	Select Health	Select Health Medicare Choice (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H2246	032	0	$5,000
23	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0015 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H2406	106	0	$5,100
24	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage Patriot No Rx CO-MA04 (PPO)	Local PPO *						H2406	108	0	$4,000
25	Colorado	Adams	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0007 (PPO)	Local PPO	$0.00	$350.00	Enhanced	EA	Yes	H2577	002	0	$6,300
26	Colorado	Adams	Kaiser Permanente	Kaiser Permanente Senior Advantage Choice DM (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	No	H3138	001	0	$5,100
27	Colorado	Adams	Aetna Medicare	Aetna Medicare Premier 1 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H3931	153	0	$4,000
28	Colorado	Adams	Anthem Blue Cross and Blue Shield	Anthem Medicare Advantage (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H4346	012	0	$6,700
29	Colorado	Adams	Aetna Medicare	Aetna Medicare Elite 1 (HMO-POS)	Local HMO	$0.00	$250.00	Enhanced	EA	Yes	H4711	006	0	$4,900
30	Colorado	Adams	Aetna Medicare	Aetna Medicare Premier 3 (HMO-POS)	Local HMO	$0.00	$250.00	Enhanced	EA	Yes	H4711	008	0	$4,500
31	Colorado	Adams	Aetna Medicare	Aetna Medicare Eagle (HMO-POS)	Local HMO *						H4711	010	0	$5,000
32	Colorado	Adams	Devoted Health	Devoted CHOICE Colorado (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H4808	002	0	$5,500
33	Colorado	Adams	Devoted Health	Devoted CHOICE GIVEBACK Colorado (PPO)	Local PPO	$0.00	$545.00	Enhanced	EA	Yes	H4808	003	0	$7,900
34	Colorado	Adams	Humana	HumanaChoice H5216-077 (PPO)	Local PPO *						H5216	077	0	$3,900
35	Colorado	Adams	Humana	HumanaChoice H5216-078 (PPO)	Local PPO	$66.00	$0.00	Enhanced	EA	Yes	H5216	078	1	$6,700
36	Colorado	Adams	Humana	HumanaChoice H5216-137 (PPO)	Local PPO	$0.00	$500.00	Enhanced	EA	No	H5216	137	0	$7,350
37	Colorado	Adams	Humana	Humana Value Plus H5216-195 (PPO)	Local PPO	$46.60	$545.00	Basic	BA	No	H5216	195	0	$7,550
38	Colorado	Adams	Humana	Humana USAA Honor (PPO)	Local PPO *						H5216	213	0	$4,900
39	Colorado	Adams	Humana	HumanaChoice H5216-223 (PPO)	Local PPO	$34.00	$0.00	Enhanced	EA	Yes	H5216	223	0	$4,900
40	Colorado	Adams	Humana	HumanaChoice H5216-261 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H5216	261	0	$5,100
41	Colorado	Adams	Humana	HumanaChoice H5216-333 (PPO)	Local PPO	$102.00	$0.00	Enhanced	EA	Yes	H5216	333	0	$2,900
42	Colorado	Adams	Aetna Medicare	Aetna Medicare Premier Plus 1 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H5521	250	0	$5,200
43	Colorado	Adams	Aetna Medicare	Aetna Medicare Eagle 1 (PPO)	Local PPO *						H5521	378	0	$5,500
44	Colorado	Adams	Aetna Medicare	Aetna Medicare Value Plus (PPO)	Local PPO	$29.00	$250.00	Enhanced	EA	Yes	H5521	443	0	$5,300
45	Colorado	Adams	Elevate Medicare Advantage	Elevate Medicare Select (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H5608	002	0	$4,900
46	Colorado	Adams	Clear Spring Health	Clear Spring Health Essential (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H6379	001	0	$3,400
47	Colorado	Adams	Devoted Health	Devoted CORE Colorado (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H7147	004	0	$3,900
48	Colorado	Adams	Devoted Health	Devoted GIVEBACK Colorado (HMO-POS)	Local HMO	$0.00	$150.00	Enhanced	EA	Yes	H7147	005	0	$5,900
49	Colorado	Adams	Cigna Healthcare	Cigna True Choice Medicare (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	No	H7849	001	0	$5,200
50	Colorado	Adams	Cigna Healthcare	Cigna True Choice Courage Medicare (PPO)	Local PPO *						H7849	126	0	$5,700
51	Colorado	Adams	Clear Spring Health	Clear Spring Health Essential (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	No	H8014	001	0	$5,500
52	Colorado	Adams	Humana	Humana Gold Choice H8145-123 (PFFS)	PFFS	$60.00	$300.00	Enhanced	EA	No	H8145	123	0
53	Colorado	Alamosa	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0006 (PPO)	Local PPO	$0.00	$400.00	Enhanced	EA	Yes	H2577	001	2	$7,550
54	Colorado	Alamosa	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0008 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H2577	003	2	$7,550
55	Colorado	Alamosa	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0010 (PPO)	Local PPO	$34.00	$0.00	Enhanced	EA	Yes	H2577	023	0	$6,300
56	Colorado	Alamosa	Humana	HumanaChoice H5216-077 (PPO)	Local PPO *						H5216	077	0	$3,900
57	Colorado	Alamosa	Humana	HumanaChoice H5216-078 (PPO)	Local PPO	$66.00	$0.00	Enhanced	EA	Yes	H5216	078	1	$6,700
58	Colorado	Alamosa	Humana	HumanaChoice H5216-137 (PPO)	Local PPO	$0.00	$500.00	Enhanced	EA	No	H5216	137	0	$7,350
59	Colorado	Alamosa	Humana	Humana Value Plus H5216-195 (PPO)	Local PPO	$46.60	$545.00	Basic	BA	No	H5216	195	0	$7,550
60	Colorado	Alamosa	Humana	Humana USAA Honor (PPO)	Local PPO *						H5216	213	0	$4,900
61	Colorado	Alamosa	Humana	HumanaChoice H5216-223 (PPO)	Local PPO	$34.00	$0.00	Enhanced	EA	Yes	H5216	223	0	$4,900
62	Colorado	Alamosa	Humana	HumanaChoice H5216-333 (PPO)	Local PPO	$102.00	$0.00	Enhanced	EA	Yes	H5216	333	0	$2,900
63	Colorado	Arapahoe	Humana	Humana Gold Plus H0028-025 (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0028	025	1	$3,900
64	Colorado	Arapahoe	Humana	Humana Gold Plus H0028-047 (HMO)	Local HMO	$24.00	$0.00	Enhanced	EA	No	H0028	047	0	$5,300
65	Colorado	Arapahoe	Humana	Humana Gold Plus H0028-063 (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0028	063	0	$5,000
66	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0001 (HMO-POS)	Local HMO	$45.00	$0.00	Enhanced	EA	Yes	H0609	007	0	$2,900
67	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0002 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0609	012	0	$3,500
68	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage Patriot No Rx CO-MA01 (HMO-POS)	Local HMO *						H0609	018	0	$3,400
69	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0005 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H0609	048	0	$3,800
70	Colorado	Arapahoe	Kaiser Permanente	Kaiser Permanente Senior Advantage Core DM (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0630	013	0	$3,900
71	Colorado	Arapahoe	Kaiser Permanente	Kaiser Permanente Senior Advantage Silver DM (HMO-POS)	Local HMO	$35.30	$0.00	Enhanced	EA	No	H0630	015	0	$3,400
72	Colorado	Arapahoe	Kaiser Permanente	Kaiser Permanente Senior Advantage Gold (HMO-POS)	Local HMO	$181.00	$0.00	Enhanced	EA	No	H0630	016	0	$3,000
73	Colorado	Arapahoe	Kaiser Permanente	Kaiser Permanente Senior Advantage Bronze DM (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0630	025	0	$4,100
74	Colorado	Arapahoe	Cigna Healthcare	Cigna Preferred Medicare (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	No	H0672	001	0	$3,860
75	Colorado	Arapahoe	Select Health	Select Health Medicare Essential (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	027	0	$3,900
76	Colorado	Arapahoe	Select Health	Select Health Medicare + Kroger (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	030	0	$3,900
77	Colorado	Arapahoe	Select Health	Select Health Medicare Flex (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H1994	031	0	$3,900
78	Colorado	Arapahoe	Select Health	Select Health Medicare Choice (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H2246	032	0	$5,000
79	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0015 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H2406	106	0	$5,100
80	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage Patriot No Rx CO-MA04 (PPO)	Local PPO *						H2406	108	0	$4,000
81	Colorado	Arapahoe	UnitedHealthcare	AARP Medicare Advantage from UHC CO-0007 (PPO)	Local PPO	$0.00	$350.00	Enhanced	EA	Yes	H2577	002	0	$6,300
82	Colorado	Arapahoe	Kaiser Permanente	Kaiser Permanente Senior Advantage Choice DM (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	No	H3138	001	0	$5,100
83	Colorado	Arapahoe	Perennial Advantage	Perennial Advantage Freedom (HMO)	Local HMO	$0.00	$545.00	Enhanced	EA	No	H3419	003	0	$3,900
84	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Premier 1 (HMO-POS)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H3931	153	0	$4,000
85	Colorado	Arapahoe	Anthem Blue Cross and Blue Shield	Anthem Medicare Advantage (HMO)	Local HMO	$0.00	$0.00	Enhanced	EA	Yes	H4346	012	0	$6,700
86	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Elite 1 (HMO-POS)	Local HMO	$0.00	$250.00	Enhanced	EA	Yes	H4711	006	0	$4,900
87	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Premier 3 (HMO-POS)	Local HMO	$0.00	$250.00	Enhanced	EA	Yes	H4711	008	0	$4,500
88	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Eagle (HMO-POS)	Local HMO *						H4711	010	0	$5,000
89	Colorado	Arapahoe	Devoted Health	Devoted CHOICE Colorado (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H4808	002	0	$5,500
90	Colorado	Arapahoe	Devoted Health	Devoted CHOICE GIVEBACK Colorado (PPO)	Local PPO	$0.00	$545.00	Enhanced	EA	Yes	H4808	003	0	$7,900
91	Colorado	Arapahoe	Humana	HumanaChoice H5216-077 (PPO)	Local PPO *						H5216	077	0	$3,900
92	Colorado	Arapahoe	Humana	HumanaChoice H5216-078 (PPO)	Local PPO	$66.00	$0.00	Enhanced	EA	Yes	H5216	078	1	$6,700
93	Colorado	Arapahoe	Humana	HumanaChoice H5216-137 (PPO)	Local PPO	$0.00	$500.00	Enhanced	EA	No	H5216	137	0	$7,350
94	Colorado	Arapahoe	Humana	Humana Value Plus H5216-195 (PPO)	Local PPO	$46.60	$545.00	Basic	BA	No	H5216	195	0	$7,550
95	Colorado	Arapahoe	Humana	Humana USAA Honor (PPO)	Local PPO *						H5216	213	0	$4,900
96	Colorado	Arapahoe	Humana	HumanaChoice H5216-223 (PPO)	Local PPO	$34.00	$0.00	Enhanced	EA	Yes	H5216	223	0	$4,900
97	Colorado	Arapahoe	Humana	HumanaChoice H5216-261 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H5216	261	0	$5,100
98	Colorado	Arapahoe	Humana	HumanaChoice H5216-333 (PPO)	Local PPO	$102.00	$0.00	Enhanced	EA	Yes	H5216	333	0	$2,900
99	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Premier Plus 1 (PPO)	Local PPO	$0.00	$0.00	Enhanced	EA	Yes	H5521	250	0	$5,200
100	Colorado	Arapahoe	Aetna Medicare	Aetna Medicare Eagle 1 (PPO)	Local PPO *						H5521	378	0	$5,500