Medicare Plans in
Madison County, IL

35 Medicare Advantage Plans Found in Madison County. See Plans

Madison County, IL
Medicare Information

For Madison County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 35 MA plans are available in Madison 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.

For Madison County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 35 MA plans are available in Madison 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.

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 Medicare Advantage plans in Madison County, Illinois, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.

Average Cost of Medicare Advantage
Plans in Madison County

Average Cost of Medicare Advantage Plans in Madison County, Illinois
Average Monthly Premium $62.35
Average in-network out-of-pocket spending limit $4,281.25
Average drug deductible in 2022 (weighted) $408.50
Percentage of plans rated 4 stars or higher 37.1%
Average Cost of Medicare Advantage Plans in Madison County, Illinois
Average Monthly Premium
$62.35
Average in-network out-of-pocket spending limit
$4,281.25
Average drug deductible in 2021 (weighted)
$408.50
Percentage of plans rated 4 stars or higher
37.1%

Learn More About Medicare Advantage
Prescription Drug Plans

Madison County Medicare beneficiaries who are interested in a Part C policy may choose among the following types of plans, depending on their needs and circumstances:
Plan Type Description
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
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.
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.
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.
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.

In addition to these primary types of plans, some members 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.

Aetna Inc. Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for Aetna Inc. Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Aetna Medicare Elite (PPO) H1608: 050 $0 $0 $4,500 Yes
3.5 out of 5
Aetna Medicare Eagle (PPO) H1608: 060 $0 N/A $5,000 No
3.5 out of 5
Aetna Medicare Gold Advantage Prime (HMO) H2663: 005 $0 $0 $2,900 Yes
4.5 out of 5
Aetna Medicare Value (PPO) H7301: 011 $0 $0 $3,900 Yes
4.5 out of 5
Aetna Medicare Option 1 (HMO-POS) H2663: 006 $34 $0 $6,900 Yes
4.5 out of 5
Aetna Medicare Premier (PPO) H1608: 013 $52 $150 $7,550 Yes
3.5 out of 5
Aetna Medicare Option 2 (HMO) H2663: 002 $66 $0 $4,900 Yes
4.5 out of 5
Cigna

Cigna Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for Cigna Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Cigna Preferred Medicare (HMO) H7389: 003 $0 $0 $2,900 Yes
na
Cigna True Choice Medicare (PPO) H7849: 057 $0 $0 $4,100 Yes
Plan too new to be measured

Clear Spring Health

Clear Spring Health Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for Clear Spring Health Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Clear Spring Health Essential (HMO) H5454: 001 $0 $0 $2,900 Yes
Plan too new to be measured

Health Care Service Corporation

Health Care Service Corporation Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for Health Care Service Corporation Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Blue Cross Medicare Advantage Basic (HMO) H3822: 013 $0 $0 $1,900 Yes
3.5 out of 5
Blue Cross Medicare Advantage Classic (PPO) H8634: 011 $0 $0 $5,000 Yes
3.5 out of 5
Blue Cross Medicare Advantage Flex (PPO) H8634: 014 $189 $480 $0 Yes
3.5 out of 5
Humana Inc.

Humana Inc. Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for Humana Inc. Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Humana Gold Plus H0028-014 (HMO) H0028: 014 $0 $0 $2,900 Yes
4 out of 5
HumanaChoice H5216-033 (PPO) H5216: 033 $0 $0 $3,600 Yes
4 out of 5
Humana Honor (PPO) H5216: 140 $0 N/A $4,500 No
4 out of 5
HumanaChoice R5361-001 (Regional PPO) R5361: 001 $0 N/A $6,700 No
3.5 out of 5
Humana Gold Choice H8145-121 (PFFS) H8145: 121 $52 N/A N/A No
3.5 out of 5
HumanaChoice H5216-032 (PPO) H5216: 032 $79 $195 $6,700 Yes
4 out of 5
HumanaChoice R5361-002 (Regional PPO) R5361: 002 $120 $480 $6,700 Yes
3.5 out of 5
Humana Gold Choice H8145-008 (PFFS) H8145: 008 $146 $380 N/A Yes
3.5 out of 5
UnitedHealthcare

UnitedHealthcare Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for UnitedHealthcare Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
AARP Medicare Advantage Walgreens (PPO) H2228: 083 $0 $0 $3,900 Yes
4 out of 5
AARP Medicare Advantage Plan 1 (HMO-POS) H2802: 028 $0 $0 $2,900 Yes
4.5 out of 5
AARP Medicare Advantage Patriot (HMO-POS) H2802: 050 $0 N/A $3,700 No
4.5 out of 5
AARP Medicare Advantage Plan 2 (HMO-POS) H2802: 052 $0 $0 $3,400 Yes
4.5 out of 5
AARP Medicare Advantage Choice (PPO) H2228: 030 $29 $0 $4,400 Yes
4 out of 5
UnitedHealthcare Medicare Advantage Assure (PPO) H0271: 019 $29 $480 $7,550 Yes
Plan too new to be measured
WellCare Health Plans, Inc.

WellCare Health Plans, Inc. Medicare Advantage Plans in Madison County, IL

The following table includes cost information and other plan details for WellCare Health Plans, Inc. Medicare Advantage plans available in Illinois in 2022.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Wellcare No Premium (HMO-POS) H1416: 009 $0 $0 $3,450 Yes
3 out of 5
Wellcare Patriot No Premium (HMO-POS) H1416: 053 $0 N/A $3,450 No
3 out of 5
Wellcare No Premium Open (PPO) H6713: 001 $0 $0 $3,450 Yes
Plan too new to be measured
Wellcare Giveback Open (PPO) H6713: 002 $0 $0 $3,450 Yes
Plan too new to be measured
Wellcare Assist (HMO) H5779: 008 $12 $480 $3,450 Yes
3.5 out of 5
Wellcare Edge Plus (HMO) H5779: 006 $19 $480 $3,450 Yes
3.5 out of 5
Wellcare Assist Compass (HMO) H1416: 023 $19 $480 $3,450 Yes
3 out of 5
Wellcare Plus (HMO) H1416: 048 $27 $480 $3,450 Yes
3 out of 5