Medicare Plans in
Carbon County, PA

45 Medicare Advantage Plans Found in Carbon County. See Plans

Carbon County, PA
Medicare Information

For Carbon County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 45 MA plans are available in Carbon 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 Carbon County’s Medicare beneficiaries, Medicare Advantage plans offer an alternative to Original Medicare. Currently, 45 MA plans are available in Carbon 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 Carbon County, Pennsylvania, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.

Average Cost of Medicare Advantage
Plans in Carbon County

Average Cost of Medicare Advantage Plans in Carbon County, Pennsylvania
Average Monthly Premium $54.52
Average in-network out-of-pocket spending limit $6,786.49
Average drug deductible in 2023 (weighted) $341.11
Percentage of plans rated 4 stars or higher 66.7%
Average Cost of Medicare Advantage Plans in Carbon County, Pennsylvania
Average Monthly Premium
$54.52
Average in-network out-of-pocket spending limit
$6,786.49
Average drug deductible in 2021 (weighted)
$341.11
Percentage of plans rated 4 stars or higher
66.7%

Learn More About Medicare Advantage
Prescription Drug Plans

Carbon 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 Carbon County, PA

The following table includes cost information and other plan details for Aetna Inc. Medicare Advantage plans available in Pennsylvania in 2023.

Scroll to the right to continue reading the chart
Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Aetna Medicare The Valley Plan (PPO) H5521: 294 $0 $0 $7,550 Yes
3.5 out of 5
Aetna Medicare Value (PPO) H5521: 263 $0 $0 $7,550 Yes
3.5 out of 5
Aetna Medicare Advantra Cares (HMO D-SNP) H3959: 036 $0 $0 $8,300 Yes
4.5 out of 5
Aetna Medicare Advantra Gold (HMO-POS) H3959: 037 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Advantra Eagle (HMO) H3959: 041 $0 N/A $4,000 No
4.5 out of 5
Aetna Medicare Advantra Silver (PPO) H5522: 004 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Advantra Credit Value (PPO) H5522: 017 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Silver Back (PPO) H5522: 022 $0 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Advantra Silver Plus (PPO) H5522: 013 $18 $0 $7,000 Yes
4.5 out of 5
Aetna Medicare Advantra Premier (HMO-POS) H3959: 039 $23 $0 $7,550 Yes
4.5 out of 5
Aetna Medicare Silver (HMO) H3931: 070 $47 $0 $7,550 Yes
3.5 out of 5
Aetna Medicare Advantra Premier Plus (PPO) H5522: 002 $77 $0 $6,500 Yes
4.5 out of 5
Aetna Medicare Gold Plan (PPO) H5521: 122 $176 $0 $7,550 Yes
3.5 out of 5
Humana Inc.

Humana Inc. Medicare Advantage Plans in Carbon County, PA

The following table includes cost information and other plan details for Humana Inc. Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
HumanaChoice H5216-116 (PPO) H5216: 116 $0 N/A $3,900 No
4.5 out of 5
Humana Honor (PPO) H5216: 221 $0 N/A $6,700 No
4.5 out of 5
HumanaChoice H5525-051 (PPO) H5525: 051 $0 $0 $7,550 Yes
4 out of 5
HumanaChoice H5525-058 (PPO) H5525: 058 $0 $505 $7,550 Yes
4 out of 5
Humana USAA Honor with Rx (PPO) H5525: 059 $0 $250 $7,550 Yes
4 out of 5
HumanaChoice H5525-060 (PPO) H5525: 060 $0 $0 $7,550 Yes
4 out of 5
Humana Gold Plus H6622-036 (HMO) H6622: 036 $0 $0 $6,700 Yes
4.5 out of 5
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) H6622: 078 $0 $0 $0 Yes
4.5 out of 5
Humana Gold Choice H8145-052 (PFFS) H8145: 052 $0 $360 N/A Yes
4 out of 5
Humana Gold Choice H8145-055 (PFFS) H8145: 055 $0 N/A N/A No
4 out of 5
HumanaChoice R0923-001 (Regional PPO) R0923: 001 $0 N/A $4,500 No
4 out of 5
HumanaChoice H5525-017 (PPO) H5525: 017 $18 $0 $4,900 Yes
4 out of 5
Humana Value Plus H5216-117 (PPO) H5216: 117 $41 $505 $7,000 Yes
4.5 out of 5
HumanaChoice H5525-005 (PPO) H5525: 005 $58 $0 $6,700 Yes
4 out of 5
HumanaChoice R0923-002 (Regional PPO) R0923: 002 $71 $0 $6,700 Yes
4 out of 5
HumanaChoice H5216-120 (PPO) H5216: 120 $123 $0 $6,700 Yes
4.5 out of 5
UnitedHealthcare

UnitedHealthcare Medicare Advantage Plans in Carbon County, PA

The following table includes cost information and other plan details for UnitedHealthcare Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
UnitedHealthcare Dual Complete Choice (PPO D-SNP) H1889: 007 $0 $0 $0 Yes
4 out of 5
AARP Medicare Advantage Patriot (HMO-POS) H1944: 030 $0 N/A $5,500 No
4 out of 5
AARP Medicare Advantage Flex (HMO-POS) H1944: 035 $0 $0 $6,700 Yes
4 out of 5
AARP Medicare Advantage Choice (PPO) H2577: 028 $0 $0 $6,700 Yes
3 out of 5
UnitedHealthcare Dual Complete (HMO-POS D-SNP) H3113: 009 $0 $0 $0 Yes
4 out of 5
UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) H3113: 014 $0 $0 $0 Yes
4 out of 5
WellCare Health Plans, Inc.

WellCare Health Plans, Inc. Medicare Advantage Plans in Carbon County, PA

The following table includes cost information and other plan details for WellCare Health Plans, Inc. Medicare Advantage plans available in Pennsylvania in 2023.

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Plan Name Plan Code Monthly Premium Deductible Out of
Pocket Max
Prescription Drug Coverage Medicare
Star Rating
Wellcare No Premium Open (PPO) H2128: 002 $0 $160 $6,700 Yes
Plan too new to be measured
Wellcare Giveback Open (PPO) H2128: 004 $0 $350 $7,550 Yes
Plan too new to be measured
Wellcare Dual Access Open (PPO D-SNP) H2128: 005 $0 $0 $0 Yes
Plan too new to be measured
Wellcare No Premium (HMO) H2915: 003 $0 $0 $6,700 Yes
2.5 out of 5
Wellcare Dual Access (HMO D-SNP) H2915: 007 $0 $0 $0 Yes
2.5 out of 5
Wellcare Giveback (HMO) H2915: 012 $0 $0 $7,550 Yes
2.5 out of 5
Wellcare Patriot Giveback (HMO) H2915: 013 $0 N/A $7,550 No
2.5 out of 5
Wellcare Assist (HMO) H2915: 011 $14 $445 $6,700 Yes
2.5 out of 5
Wellcare Assist Open (PPO) H2128: 001 $14 $395 $6,700 Yes
Plan too new to be measured
Wellcare Low Premium Open (PPO) H2128: 003 $29 $100 $5,000 Yes
Plan too new to be measured