Medicare Plans in
Effingham County, IL
23 Medicare Advantage Plans Found in Effingham County. See Plans
Effingham County, IL
Medicare Information
For Effingham County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.
Currently, 23 private Medicare plans are available in Effingham County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.
MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.
Part D plans, also referred to as PDPs, cover retail prescription drugs.
Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.
Learn more about some of the Medicare plans in Effingham County, Illinois, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.
Average Cost of Medicare
Plans in Effingham County
Average Cost of Medicare Advantage Plans in Effingham County, Illinois | |
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Average Monthly Premium | $89.10 |
Average in-network out-of-pocket spending limit | $4,870.45 |
Average drug deductible in 2024 (weighted) | $495.83 |
Percentage of plans rated 4 stars or higher | 56.5% |
Average Cost of Medicare Advantage Plans in Effingham County, Illinois |
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Average Monthly Premium $89.10 |
Average in-network out-of-pocket spending limit $4,870.45 |
Average drug deductible in 2021 (weighted) $495.83 |
Percentage of plans rated 4 stars or higher 56.5% |
Learn More About Medicare
Prescription Drug Plans
Plan Type | Description |
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HMO | HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage. |
PPO | Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage. |
PFFS | Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans. |
SNP | Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage. |
Plan Type and Description |
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HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
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Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
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Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
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Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.
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Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.
Medicare Advantage Plans
Aetna Inc. Medicare Plans in Effingham County, IL
The following table includes cost information and other plan details for Aetna Inc. private Medicare plans available in Illinois in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Aetna Medicare Value (PPO) | H7301: 007 | $0 | $0 | $4,650 | Yes | 4 out of 5 |
Aetna Medicare Premier (PPO) | H7301: 009 | $13 | $0 | $4,650 | Yes | 4 out of 5 |
Aetna Medicare Discover Value Plus (PPO) | H7301: 017 | $28 | $0 | $3,950 | Yes | 4 out of 5 |
Health Care Service Corporation
Health Care Service Corporation Medicare Plans in Effingham County, IL
The following table includes cost information and other plan details for Health Care Service Corporation private Medicare plans available in Illinois in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Blue Cross Medicare Advantage Classic (PPO) | H8634: 017 | $0 | $0 | $5,900 | Yes | 3 out of 5 |
Blue Cross Medicare Advantage Health Choice (PPO) | H8634: 018 | $0 | $545 | $6,900 | Yes | 3 out of 5 |
Blue Cross Medicare Advantage Protect (PPO) | H8634: 019 | $0 | N/A | $6,350 | No | 3 out of 5 |
Blue Cross Medicare Advantage Dental Premier (PPO) | H8634: 021 | $0 | $545 | $7,550 | Yes | 3 out of 5 |
Blue Cross Medicare Advantage Basic (HMO) | H3822: 012 | $0 | $0 | $4,900 | Yes | 2.5 out of 5 |
Blue Cross Medicare Advantage Flex (PPO) | H8634: 014 | $202 | $545 | N/A | Yes | 3 out of 5 |
Humana Inc. Medicare Plans in Effingham County, IL
The following table includes cost information and other plan details for Humana Inc. private Medicare plans available in Illinois in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
HumanaChoice H5525-068 (PPO) | H5525: 068 | $0 | $250 | $4,200 | Yes | 4 out of 5 |
Humana USAA Honor (Regional PPO) | R5361: 001 | $0 | N/A | $5,500 | No | 4 out of 5 |
Humana USAA Honor (PPO) | H5216: 355 | $0 | N/A | $5,500 | No | 4.5 out of 5 |
HumanaChoice H5216-399 (PPO) | H5216: 399 | $30 | $0 | $3,900 | Yes | 4.5 out of 5 |
HumanaChoice R5361-002 (Regional PPO) | R5361: 002 | $97 | $545 | $6,700 | Yes | 4 out of 5 |
The Carle Foundation
The Carle Foundation Medicare Plans in Effingham County, IL
The following table includes cost information and other plan details for The Carle Foundation private Medicare plans available in Illinois in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Health Alliance Medicare POS Choice Rx (HMO-POS) | H1463: 044 | $0 | $0 | $3,500 | Yes | 4 out of 5 |
Health Alliance Medicare HMO Basic (HMO) | H1463: 008 | $0 | N/A | $6,700 | No | 4 out of 5 |
Health Alliance Medicare POS Basic Rx (HMO-POS) | H1463: 015 | $53 | $0 | $5,400 | Yes | 4 out of 5 |
Health Alliance Medicare HMO 20 Rx (HMO) | H1463: 003 | $125 | $0 | $4,000 | Yes | 4 out of 5 |
Health Alliance Medicare POS 10 Rx (HMO-POS) | H1463: 019 | $165 | $0 | $2,900 | Yes | 4 out of 5 |
Wellcare Health Plans, Inc. Medicare Plans in Effingham County, IL
The following table includes cost information and other plan details for Wellcare Health Plans, Inc. private Medicare plans available in Illinois in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Wellcare No Premium Open (PPO) | H6713: 001 | $0 | $0 | $3,200 | Yes | 2.5 out of 5 |
Wellcare No Premium Essential (HMO) | H5779: 002 | $0 | $0 | $2,900 | Yes | 3 out of 5 |
Wellcare Giveback Open (PPO) | H6713: 002 | $0 | $545 | $5,000 | Yes | 2.5 out of 5 |
Wellcare No Premium Essential Value (HMO) | H5779: 009 | $0 | $0 | $2,900 | Yes | 3 out of 5 |