Medicare Plans in
Macomb County, MI
53 Medicare Advantage Plans Found in Macomb County. See Plans
Macomb County, MI
Medicare Information
For Macomb County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 53 MA plans are available in Macomb 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 Macomb County, Michigan, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
Average Cost of Medicare Advantage
Plans in Macomb County
Average Cost of Medicare Advantage Plans in Macomb County, Michigan | |
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Average Monthly Premium | $97.60 |
Average in-network out-of-pocket spending limit | $4,598.44 |
Average drug deductible in 2022 (weighted) | $285.42 |
Percentage of plans rated 4 stars or higher | 49.1% |
Average Cost of Medicare Advantage Plans in Macomb County, Michigan |
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Average Monthly Premium $97.60 |
Average in-network out-of-pocket spending limit $4,598.44 |
Average drug deductible in 2021 (weighted) $285.42 |
Percentage of plans rated 4 stars or higher 49.1% |
Learn More About Medicare Advantage
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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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. Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Aetna Inc. Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Aetna Medicare Premier (HMO-POS) | H3192: 003 | $0 | $0 | $3,900 | Yes | Plan too new to be measured |
Aetna Medicare Value (PPO) | H5521: 214 | $0 | $0 | $4,950 | Yes | 4 out of 5 |
Aetna Medicare Eagle (PPO) | H5521: 286 | $0 | N/A | $5,500 | No | 4 out of 5 |
Aetna Medicare Premier Plus (PPO) | H5521: 217 | $29 | $0 | $5,100 | Yes | 4 out of 5 |
Blue Cross Blue Shield of Michigan Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Blue Cross Blue Shield of Michigan Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
BCN Advantage HMO-POS Prime Value (HMO-POS) | H5883: 014 | $0 | $50 | N/A | Yes | 4 out of 5 |
Medicare Plus Blue PPO Essential (PPO) | H9572: 004 | $10 | $0 | $6,000 | Yes | 3.5 out of 5 |
BCN Advantage HMO-POS Community Value (HMO-POS) | H5883: 012 | $20 | $0 | N/A | Yes | 4 out of 5 |
BCN Advantage HMO-POS Elements (HMO-POS) | H5883: 001 | $34 | N/A | N/A | No | 4 out of 5 |
BCN Advantage HMO ConnectedCare (HMO) | H5883: 007 | $58 | $0 | $3,800 | Yes | 4 out of 5 |
Medicare Plus Blue PPO Vitality (PPO) | H9572: 002 | $85 | $0 | $5,000 | Yes | 3.5 out of 5 |
BCN Advantage HMO-POS Classic (HMO-POS) | H5883: 002 | $124 | $0 | N/A | Yes | 4 out of 5 |
Medicare Plus Blue PPO Signature (PPO) | H9572: 001 | $152 | $0 | $4,700 | Yes | 3.5 out of 5 |
BCN Advantage HMO-POS Prestige (HMO-POS) | H5883: 003 | $238 | $0 | N/A | Yes | 4 out of 5 |
Medicare Plus Blue PPO Assure (PPO) | H9572: 003 | $301 | $0 | $3,425 | Yes | 3.5 out of 5 |
Centene Corporation
Centene Corporation Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Centene Corporation Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Ascension Complete Michigan Reward (HMO) | H0482: 003 | $0 | $480 | $2,900 | Yes | Plan too new to be measured |
Ascension Complete Michigan Secure (HMO) | H0482: 004 | $0 | $0 | $2,900 | Yes | Plan too new to be measured |
Ascension Complete Michigan Access Plus (PPO) | H7512: 001 | $0 | $0 | $3,450 | Yes | na |
Ascension Complete Michigan Access (PPO) | H7512: 002 | $0 | $0 | $2,900 | Yes | na |
Health Alliance Plan
Health Alliance Plan Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Health Alliance Plan Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
HAP Senior Plus Option 1 (PPO) | H2322: 011 | $0 | $0 | $6,500 | Yes | 4 out of 5 |
HAP Senior Plus (HMO) | H2354: 015 | $0 | $0 | $4,500 | Yes | 4.5 out of 5 |
HAP Senior Plus Medical Only (HMO) | H2354: 019 | $0 | N/A | $4,000 | No | 4.5 out of 5 |
HAP Primary Choice Medicare (HMO) | H2354: 024 | $0 | $0 | $4,300 | Yes | 4.5 out of 5 |
HAP Senior Plus Option 2 (PPO) | H2322: 012 | $65 | $0 | $5,000 | Yes | 4 out of 5 |
HAP Senior Plus Option 1 (HMO-POS) | H2354: 021 | $90 | $0 | $4,200 | Yes | 4.5 out of 5 |
HAP Senior Plus Henry Ford Tiered Access (HMO) | H2354: 018 | $95 | $0 | $4,500 | Yes | 4.5 out of 5 |
HAP Senior Plus Option 3 (PPO) | H2322: 008 | $165 | $0 | $4,500 | Yes | 4 out of 5 |
HAP Senior Plus Option 2 (HMO-POS) | H2354: 022 | $190 | $0 | $4,000 | Yes | 4.5 out of 5 |
HAP Senior Plus Option 4 (PPO) | H2322: 004 | $200 | $0 | $4,000 | Yes | 4 out of 5 |

Humana Inc. Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Humana Inc. Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Humana Honor (PPO) | H5216: 190 | $0 | N/A | $5,500 | No | 4 out of 5 |
HumanaChoice H5216-287 (PPO) | H5216: 287 | $0 | $150 | $5,200 | Yes | 4 out of 5 |
Humana Gold Plus H8908-004 (HMO) | H8908: 004 | $0 | $0 | $4,900 | Yes | 3 out of 5 |
HumanaChoice R3887-001 (Regional PPO) | R3887: 001 | $0 | N/A | $5,500 | No | 3.5 out of 5 |
HumanaChoice H5216-133 (PPO) | H5216: 133 | $22 | $150 | $6,400 | Yes | 4 out of 5 |
Humana Gold Plus H8908-001 (HMO) | H8908: 001 | $46 | $0 | $3,900 | Yes | 3 out of 5 |
HumanaChoice H5216-011 (PPO) | H5216: 011 | $100 | $0 | $5,900 | Yes | 4 out of 5 |
HumanaChoice R3887-002 (Regional PPO) | R3887: 002 | $112 | $480 | $5,300 | Yes | 3.5 out of 5 |
Molina Healthcare, Inc.,
Molina Healthcare, Inc., Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Molina Healthcare, Inc., Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Molina Medicare Choice Care (HMO) | H5926: 006 | $0 | $125 | $7,550 | Yes | 3.5 out of 5 |
Priority Health
Priority Health Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for Priority Health Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
PriorityMedicare Key (HMO-POS) | H2320: 022 | $0 | $0 | $5,500 | Yes | 4 out of 5 |
PriorityMedicare Edge (PPO) | H4875: 020 | $0 | $0 | $5,300 | Yes | 3.5 out of 5 |
PriorityMedicare Vital (PPO) | H4875: 022 | $0 | $350 | $4,700 | Yes | 3.5 out of 5 |
PriorityMedicare Ideal (PPO) | H4875: 018 | $24 | $125 | $5,800 | Yes | 3.5 out of 5 |
PriorityMedicare Value (HMO-POS) | H2320: 029 | $72 | $75 | $4,900 | Yes | 4 out of 5 |
PriorityMedicare Merit (PPO) | H4875: 016 | $107 | $0 | $4,100 | Yes | 3.5 out of 5 |
PriorityMedicare (HMO-POS) | H2320: 028 | $119 | $0 | $4,500 | Yes | 4 out of 5 |
PriorityMedicare Select (PPO) | H4875: 017 | $208 | $0 | $3,500 | Yes | 3.5 out of 5 |

WellCare Health Plans, Inc. Medicare Advantage Plans in Macomb County, MI
The following table includes cost information and other plan details for WellCare Health Plans, Inc. Medicare Advantage plans available in Michigan in 2022.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Wellcare No Premium Open (PPO) | H2117: 001 | $0 | $0 | $5,000 | Yes | na |
Wellcare Patriot Giveback Open (PPO) | H2117: 003 | $0 | N/A | $5,000 | No | na |
Wellcare No Premium (HMO-POS) | H5475: 026 | $0 | $0 | $3,450 | Yes | 3.5 out of 5 |
Wellcare Giveback (HMO) | H5475: 031 | $0 | $480 | $3,450 | Yes | 3.5 out of 5 |
Wellcare No Premium Exclusive (HMO) | H5475: 033 | $0 | $0 | $3,450 | Yes | 3.5 out of 5 |
Wellcare Low Premium (HMO-POS) | H5475: 024 | $15 | $0 | $3,450 | Yes | 3.5 out of 5 |
Wellcare Assist (HMO) | H5475: 038 | $21 | $480 | $3,450 | Yes | 3.5 out of 5 |
Wellcare Community Assist (PPO) | H2117: 004 | $32 | $480 | $5,000 | Yes | na |