Compare & Enroll — Part C & Part D

Compare & Enroll in Medicare Plans in 21218, MD

With 31 Medicare Advantage options from 10 insurers, 21218, MD has fewer plan options than the national average, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 74% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 10 hospitals within 25.0 miles, most local plan networks should offer strong provider access. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.

📊 Direct from CMS 🚫 No agents or commissions ✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →

Data freshness: CMS data as of February 2026 • ACS data as of 2023 • Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead • View our methodology

Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
31
Part D Plans
10
Top MA Star
4.0
Top Drug Star
3.5
Happy senior couple reviewing Medicare plan options together

Medicare Eligibility in 21218, MD

Approximately 7,005 residents (15.6% of the population) in 21218, MD are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.

The median household income in 21218, MD is $68,325 (9.1% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.

Part C: Medicare Advantage Plans

Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. 21218, MD's 31 Medicare Advantage plans are predominantly HMO-based (28 HMO vs. 3 PPO), meaning most require referrals and in-network care. 23 plans offer $0 monthly premiums. The average local star rating is 3.5 out of 5, with the top plan earning 4.0 ★.

Top Medicare Advantage Plans in 21218, MD

We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in 21218, MD range from $0 to $72/month. Among rated plans, 6 plans rated 4+ stars.

Highest CMS Star Ratings

Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.

Plan NameInsurerStar RatingPremiumType
Kaiser Permanente Medicare Advantage Standard 2 Md (HMO-POS)Kaiser Permanente4.0 ★$38.00/moHMO-POSEnroll
Kaiser Permanente Medicare Advantage High Md (HMO-POS)Kaiser Permanente4.0 ★$71.70/moHMO-POSEnroll
Kaiser Permanente Dual Complete Plan 2 Md (HMO D-SNP)Kaiser Permanente4.0 ★$0.00/moHMO D-SNPEnroll
Kaiser Permanente Dual Essential Plan 2 Md (HMO D-SNP)Kaiser Permanente4.0 ★$0.00/moHMO D-SNPEnroll
Kaiser Permanente Medicare Advantage Liberty (HMO)Kaiser Permanente4.0 ★$0.00/moHMOEnroll

Lowest Monthly Premium

Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.

Plan NameInsurerMonthly PremiumMOOPStar Rating
Uhc Dual Complete Md-S002 (HMO D-SNP)Unitedhealthcare$0.00/mo$9,2503.5 ★
Carefirst Bluecross Blueshield Advantage Dualprime (HMO D-SNP)Carefirst Bluecross Blueshield Medicare Advantage Dual Prime$0.00/mo$8,8503.5 ★
Uhc Dual Complete Md-Q001 (HMO-POS D-SNP)Unitedhealthcare$0.00/mo$9,2503.5 ★
Alterwood Advantage Select (HMO)Alterwood Advantage$0.00/mo$7,5003.5 ★
Alterwood Advantage Choice (HMO)Alterwood Advantage$0.00/mo$7,5003.5 ★

Lowest Maximum Out-of-Pocket (MOOP)

MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.

Plan NameInsurerMOOP (In-Network)PremiumStar Rating
Provider Partners Maryland Community Plan (HMO I-SNP)Provider Partners Health Plans$3,750$0.00/moN/A
Kaiser Permanente Medicare Advantage High Md (HMO-POS)Kaiser Permanente$5,700$71.70/mo4.0 ★
Carefirst Bluecross Blueshield Advantage Salute (PPO)Carefirst Bluecross Blueshield Medicare Advantage$5,900$0.00/mo3.5 ★
Kaiser Permanente Medicare Advantage Liberty (HMO)Kaiser Permanente$5,900$0.00/mo4.0 ★
Alterwood Advantage Choice Plus (HMO)Alterwood Advantage$6,500$31.30/mo3.5 ★

Plan Type Mix in 21218, MD

HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.

Plan TypeCountPercentageDescription
HMO1032.3%Requires referrals; in-network only
HMO D-SNP722.6%Medicare Advantage plan
HMO I-SNP516.1%Medicare Advantage plan
HMO C-SNP39.7%Medicare Advantage plan
PPO26.5%No referrals; in and out-of-network
HMO-POS26.5%HMO with some out-of-network options
HMO-POS D-SNP13.2%Medicare Advantage plan
PPO I-SNP13.2%Medicare Advantage plan

Choosing the Right Medicare Advantage Plan

The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:

  • Provider network: Verify your doctors and hospitals near 21218, MD are in-network before enrolling
  • Total cost: A $0 premium may have higher copays—calculate your annual cost
  • Star Ratings: 4+ stars indicate above-average quality and member satisfaction

Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →

Medicare Advantage Insurers in 21218, MD

10 insurance companies offer Medicare Advantage plans in 21218, MD. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.

Kaiser Permanente
Avg Star Rating
4.0 ★
5 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Kaiser Permanente Medicare Advantage Liberty (HMO)
$0.00/mo
$5,900
4.0 ★
HMO
Kaiser Permanente Dual Complete Plan 2 Md (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Kaiser Permanente Dual Essential Plan 2 Md (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Kaiser Permanente Medicare Advantage Standard 2 Md (HMO-POS)
$38.00/mo
$8,900
4.0 ★
HMO-POS
Kaiser Permanente Medicare Advantage High Md (HMO-POS)
$71.70/mo
$5,700
4.0 ★
HMO-POS
Unitedhealthcare
Avg Star Rating
3.7 ★
3 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Uhc Nursing Home Plan Ex-F004 (PPO I-SNP)
$0.00/mo
$9,250
4.0 ★
PPO I-SNP
Uhc Dual Complete Md-Q001 (HMO-POS D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO-POS D-SNP
Uhc Dual Complete Md-S002 (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Alterwood Advantage
Avg Star Rating
3.5 ★
6 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Alterwood Advantage Freedom (HMO)
$0.00/mo
$9,250
3.5 ★
HMO
Alterwood Advantage Dual Secure (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Alterwood Advantage Dual Value (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Alterwood Advantage Choice (HMO)
$0.00/mo
$7,500
3.5 ★
HMO
Alterwood Advantage Select (HMO)
$0.00/mo
$7,500
3.5 ★
HMO
Alterwood Advantage Choice Plus (HMO)
$31.30/mo
$6,500
3.5 ★
HMO
Humana
Avg Star Rating
3.5 ★
2 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Humana Usaa Honor Giveback (HMO)
$0.00/mo
$6,750
3.5 ★
HMO
Humana Gold Plus H6622-081 (HMO)
$26.70/mo
$8,950
3.5 ★
HMO
Carefirst Bluecross Blueshield Medicare Advantage
Avg Star Rating
3.5 ★
2 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Carefirst Bluecross Blueshield Advantage Salute (PPO)
$0.00/mo
$5,900
3.5 ★
PPO
Carefirst Bluecross Blueshield Advantage Complete (PPO)
$9.90/mo
$7,300
3.5 ★
PPO
Carefirst Bluecross Blueshield Medicare Advantage Dual Prime
Avg Star Rating
3.5 ★
1 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Carefirst Bluecross Blueshield Advantage Dualprime (HMO D-SNP)
$0.00/mo
$8,850
3.5 ★
HMO D-SNP
Healthspring
Avg Star Rating
3.0 ★
5 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Healthspring Courage (HMO)
$0.00/mo
$6,750
3.0 ★
HMO
Healthspring Totalcare Plus (HMO D-SNP)
$0.00/mo
$9,250
3.0 ★
HMO D-SNP
Healthspring Alliance (HMO)
$18.00/mo
$9,200
3.0 ★
HMO
Healthspring Achieve (HMO C-SNP)
$28.60/mo
$7,950
3.0 ★
HMO C-SNP
Healthspring Preferred Plus (HMO)
$37.00/mo
$9,000
3.0 ★
HMO
Provider Partners Health Plans
Avg Star Rating
N/A
3 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Provider Partners Maryland Essential Plan (HMO I-SNP)
$0.00/mo
$9,250
N/A
HMO I-SNP
Provider Partners Maryland Advantage Plan (HMO I-SNP)
$0.00/mo
$9,250
N/A
HMO I-SNP
Provider Partners Maryland Community Plan (HMO I-SNP)
$0.00/mo
$3,750
N/A
HMO I-SNP
Communicare Advantage
Avg Star Rating
N/A
2 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Communicare Advantage Isnp (HMO I-SNP)
$0.00/mo
$9,250
N/A
HMO I-SNP
Communicare Advantage Csnp (HMO C-SNP)
$0.00/mo
$9,250
N/A
HMO C-SNP
Keycare Advantage
Avg Star Rating
N/A
2 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Keycare Advantage Plus (HMO C-SNP)
$0.00/mo
$6,900
N/A
HMO C-SNP
Keycare Advantage (HMO I-SNP)
$0.00/mo
$8,950
N/A
HMO I-SNP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Part D: Prescription Drug Plans (PDP)

Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 10 standalone Part D plans in 21218, MD, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.

Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.

Top Part D Drug Plans in 21218, MD

We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in 21218, MD range from $0 to $109/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.

Highest CMS Star Ratings (Part D)

Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.

Plan NameInsurerStar RatingPremiumDeductible
Wellcare Classic (PDP)Wellcare3.5 ★$5.70/mo$615Enroll
Wellcare Value Script (PDP)Wellcare3.5 ★$5.60/mo$615Enroll
Silverscript Choice (PDP)Aetna Medicare3.0 ★$97.40/mo$615Enroll
Humana Basic Rx Plan (PDP)Humana3.0 ★$0.00/mo$615Enroll
Humana Value Rx Plan (PDP)Humana3.0 ★$4.30/mo$601Enroll

Lowest Monthly Premium

Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.

Plan NameInsurerMonthly PremiumDrug DeductibleStar Rating
Humana Basic Rx Plan (PDP)Humana$0.00/mo$6153.0 ★
Humana Value Rx Plan (PDP)Humana$4.30/mo$6013.0 ★
Wellcare Value Script (PDP)Wellcare$5.60/mo$6153.5 ★
Wellcare Classic (PDP)Wellcare$5.70/mo$6153.5 ★
Healthspring Assurance Rx (PDP)Healthspring$32.60/mo$6152.5 ★

Lowest Annual Drug Deductible

The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.

Plan NameInsurerDrug DeductibleMonthly PremiumStar Rating
Humana Premier Rx Plan (PDP)Humana$0$108.60/mo3.0 ★
Aarp Medicare Rx Preferred From Uhc (PDP)Unitedhealthcare$130$94.50/mo2.0 ★
Humana Value Rx Plan (PDP)Humana$601$4.30/mo3.0 ★
Humana Basic Rx Plan (PDP)Humana$615$0.00/mo3.0 ★
Wellcare Value Script (PDP)Wellcare$615$5.60/mo3.5 ★
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →

Choosing the Right Part D Drug Plan

The right Part D plan depends on your specific medications. Key factors to evaluate:

  • Formulary: Verify your drugs are covered before enrolling
  • Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
  • Total annual cost: Premium + deductible + copays for your drugs

Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →

Part D Drug Plan Insurers in 21218, MD

5 insurance companies offer standalone Part D drug plans in 21218, MD. Below, we group plans by insurer.

Wellcare
Avg Star Rating
3.5 ★
2 plans
From $5.60/mo
Plan
Premium
Deductible
Stars
Type
Wellcare Value Script (PDP)
$5.60/mo
$615
3.5 ★
PDP
Wellcare Classic (PDP)
$5.70/mo
$615
3.5 ★
PDP
Humana
Avg Star Rating
3.0 ★
3 plans
From $0.00/mo
Plan
Premium
Deductible
Stars
Type
Humana Basic Rx Plan (PDP)
$0.00/mo
$615
3.0 ★
PDP
Humana Value Rx Plan (PDP)
$4.30/mo
$601
3.0 ★
PDP
Humana Premier Rx Plan (PDP)
$108.60/mo
$0
3.0 ★
PDP
Aetna Medicare
Avg Star Rating
3.0 ★
1 plans
From $97.40/mo
Plan
Premium
Deductible
Stars
Type
Silverscript Choice (PDP)
$97.40/mo
$615
3.0 ★
PDP
Healthspring
Avg Star Rating
2.5 ★
2 plans
From $32.60/mo
Plan
Premium
Deductible
Stars
Type
Healthspring Assurance Rx (PDP)
$32.60/mo
$615
2.5 ★
PDP
Healthspring Extra Rx (PDP)
$66.60/mo
$615
2.5 ★
PDP
Unitedhealthcare
Avg Star Rating
2.0 ★
2 plans
From $37.80/mo
Plan
Premium
Deductible
Stars
Type
Aarp Medicare Rx Saver From Uhc (PDP)
$37.80/mo
$615
2.0 ★
PDP
Aarp Medicare Rx Preferred From Uhc (PDP)
$94.50/mo
$130
2.0 ★
PDP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Ready to Enroll in 21218, MD?

Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.

Compare Plans at Medicare.gov Call 1-800-MEDICARE

📋 Print our Medicare Enrollment Checklist — gather your info before you compare.

📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor

Medicare.gov is the official U.S. government site for Medicare. Available 24/7.

Pharmacy Access in 21218, MD

Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around 21218, MD.

Total Pharmacies

194
within 5.0 miles

Chain Pharmacies

56
CVS, Walgreens, etc.

Independent Pharmacies

138
locally owned
PharmacyAddress & PhoneDistanceType
GIANT OF MARYLAND LLC601 E 33RD ST BALTIMORE, MD 212183505📞 410-064-41810.1 miChain
CITICARE PHARMACY AND MEDICAL EQUIPMENT, LLC3403 GREENMOUNT AVE BALTIMORE, MD 212182824📞 410-026-55510.2 miIndependent
WALGREEN CO3133 GREENMOUNT AVE BALTIMORE, MD 21218📞 410-046-14120.2 miChain
PEOPLES COMMUNITY HEALTH CENTERS3013 GREENMOUNT AVE BALTIMORE, MD 212183939📞 443-387-77920.3 miIndependent
ALPHA HEALTHCARE GROUP LLC418 E 30TH ST BALTIMORE, MD 212183934📞 410-088-07270.3 miIndependent
UNION MEMORIAL HOSPITAL-PHARMACY DEPT201 EAST UNIVERSITY PARKWAY BALTIMORE, MD 212182895📞 410-055-25550.5 miIndependent
THE PAVILION CORPORATION453 E 28TH ST BALTIMORE, MD 212184426📞 410-046-44710.5 miIndependent
MARYLAND CVS PHARMACY, L.L.C.3200 ST. PAUL ST. BALTIMORE, MD 21218📞 410-024-10250.6 miChain
TOTAL HEALTH CARE INC2400 KIRK AVE BALTIMORE, MD 212185507📞 410-073-53970.8 miIndependent
SECOND CHANCE BEHAVIORAL HEALTH CENTER LLC2502 MARYLAND AVE BALTIMORE, MD 212184510📞 410-050-40981.0 miIndependent

Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.

Local Healthcare Access in 21218, MD

Before choosing a plan, consider the healthcare infrastructure in 21218, MD. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.

Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.

Hospitals Nearby

10
within 25.0 miles

Top-Rated Hospitals near 21218, MD

If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near 21218, MD — click a hospital name to see its full profile and verify it's in your plan's network.

View all 10 hospitals near 21218, MD to check quality before you enroll →

Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of 21218, MD.

Questions to ask your doctor about Medicare coverage →

Telehealth in 21218, MD: Is Your Internet Ready?

Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in 21218, MD. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.

Internet Coverage in 21218, MD

Fiber Available
75.3%
of households
Cable/DSL Available
98.7%
of households
Top Provider
Talkie Communications
1.4% coverage
No Broadband
6.8%
of households

Internet coverage data from ISP Reports. View full internet report for 21218, MD.

Medicare-Relevant Demographics in 21218, MD

Understanding 21218, MD's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.

Total Population
44,807
Population 65+
7,005
15.6% of total
Median Age
37
0.8 years younger than the national average
Median Income
$68,325
9.1% below the National Average
On Medicare
6,601
14.7% of residents
On Medicaid
11,231
25.1% of residents
Uninsured
2,722
6.1% of residents
Social Security Recipients
11,741
26.2% of population

Demographic data from U.S. Census Bureau American Community Survey (2023). View full 21218, MD demographics (BestNeighborhood.org).

Local Medicare FAQ: 21218, MD

Common decision points based on 21218, MD's specific plan market and local healthcare landscape.

How does 21218, MD's Medicare Advantage market compare?

21218, MD has 31 Medicare Advantage plans from 10 insurers. This is below the national average of approximately 57 plans. In areas with fewer competing plans, it's especially important to compare the available options carefully. The local mix includes 28 HMO and 3 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).

Should I choose an HMO or PPO Medicare Advantage plan in 21218, MD?

With 10 hospitals within 25.0 miles, 21218, MD has strong provider density. HMO plans (28 available) typically have lower premiums but require referrals and in-network care. PPO plans (3 available) offer more flexibility to see out-of-network providers at higher cost. In 21218, MD, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.

What's the real cost of $0 premium plans in 21218, MD?

23 plans (74% of available options) in 21218, MD charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In 21218, MD, maximum out-of-pocket limits range from $3,750 to an average of $8,145. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.

How does the 2026 $2,000 drug cap affect 21218, MD beneficiaries?

The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 10 standalone Part D plans in 21218, MD.

What this means locally:

  • Cost predictability — No matter which of the 10 Part D plans you choose, your drug costs are capped at $2,000/year
  • $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
  • Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility

While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.

See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions

About the Data & Editorial Team

Wes Ward

Wes Ward

Founder & Data Lead

Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.

With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.

Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.

View full profile →LinkedIn

Transparency & Disclosures

InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.

TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.

Sources

All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.

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