最高支付	家庭医生	专科医生	住院	门诊手术	药费首付	首选常药	常药	首选品牌药	品牌药	特种药
AetnaMedicare Signature Plan	PPO	H2293-016	6750	0	70	450/Day	450	615	0	0	24%	25%	25%
Aetna Medicare Signature Extra Plan	HMO	H4523-015	6750	0	40	350/day	350	615	0	0	24%	25%	25%
Aetna Medicare Prime Plan	HMO	H4523-024	4200	0	30	335/day	335	300	0	10	25%	26%	29%
Blue Cross Medicare Advantage Basic	HMO	H8133-001	6750	0	32	395/day	375	450	0	1	20%	42%	27%
Blue Cross Medicare Advantage Dental Value	HMO	H9706-007	5200	0	34	390/day	375	615	0	1	17%	33%	25%
Blue Cross Medicare Advantage Saver	HMO	H9706-008	7500	0	20	340/day	390	450	0	1	18%	39%	27%
Blue Cross Medicare Advantage Secure	HMO	H9706-005	4200	0	22	350/day	320	450	0	1	18%	38%	27%
Devoted Core  001 TX	HMO	H7993-001	3650	0	25	325/stsy	425	240	0	0	20%	20%	29%
Devoted Core  019 TX	HMO	H7993-019	3650	0	30	325/stsy	425	220	0	0	19%	25%	28%
Devoted Core GiveBack 006TX	HMO	H7993-006	7200	0	45	425/day	525	605	0	0	24%	25%	25%
HealthSpring True Choice	PPO	H7849-154	6800	0	40	235/day	375	250	0	5	47	50%	30%
HealthSpring Preferred	HMO	H4513-061	3500	0	20	230/stay	150	200	0	2	47	50%	30%
HealthSpring Preferred Full Saving	HMO	4513-091	7500	0	50	340/day	350	500	0	0	47	50%	27%
HealthSpring Preferred Saving	HMO	4513-083	6900	0	45	325/day	350	300	0	2	47	50%	29%
HealthSpring Alliance	HMO	4513-064	2900	0	10	225/stay	125	200	0	2	47	50%	30%
Humana Gold Plus	HMO	H0028-042	3450	0	20	150/day	200	340	0	5	47	48%	29%
Humana Gold Plus	HMO	H0028-072	3400	0	15	350/stay	200	615	0	5	47	48%	25%
Humana Total Complete	HMO	H4461-049	3400	0	15	350/stay	200	615	0	5	47	48%	25%
Humana Gold Plus	HMO	H4461-057	3450	0	20	150/day	200	340	0	5	47	48%	25%
Humana Value Choice	PPO	H7617-057	6800	0	30	340/day	300	420	0	5	47	48%	28%
Humana Choice  Giveback	PPO	H5216-358	8300	0	40	310/day	350	390	0	1	30	37%	28%
KelseyCare Advantage  Freedom	HMO-POS	H0332-004	6750	0	35	375/day	350	200	0	5	40	35%	30%
KelseyCare Advantage Signature	HMO	H0332-009	3900	0	20	150/day	300	0	0	4	20%	30%	30%
Memorial Hermann  Advantage HMO	HMO	H7115-001	3400	0	25	400/stay	200	200	0	5	23%	44%	30%
SCAN Classic Texas	HMO	H8902-005	2900	0	15	95/day	100	0	0	0	42	35%	33%
AARP Medicare Advantage from UHC TX-0009	HMO-POS	H4514-007	6700	0	55	450/day	450	520	0	14	15%	37%	27%
AARP Medicare Advantage from UHC tx_001P	HMO-POS	H4514-014	4500	0	30	450/stsy	450	440	0	0	18%	41%	28%
AARP Medicare Advantage from UHC tx_0015	HMO-POS	H4527-037	4800	0	35	495/stsy	495	520	0	12	15%	40%	27%
AARP Medicare Advantage Giveback from UHC TX-31	PPO	H1278-021	8500	0	55	485/day	485	600	0	14	15%	38%	26%
Verda Noble Care	HMO	H5163-001	1599	0	0	0/stay	90	300	0	0	35	30%	29%
Wellcare Simple	HMO	H0174-010	350	0	15	325/day	280	615	0	0	25%	35%	25%
Wellcare  GiveBack	HMO	H0174-019	6900	0	50	395/day	350	615	0	0	25%	46%	25%
Wellcare TexasPlus Classic  Simple	HMO-POS	H4506-003	3400	0	15	325/stay	200	615	0	0	25%	37%	25%
WellPoint  Select	HMO-POS	H8849-009	3400	0	20	120/day	50	0	0	0	20%	30%	33%

 

			急诊	救护车	健身房	接送	助听器	眼镜/年	牙齿	OTC/3M	每月退款	人数
AetnaMedicare Signature Plan	PPO	H2293-016	130	310	Y		500	100	prevention			16,067
Aetna Medicare Signature Extra Plan	HMO	H4523-015	130	310	Y		750	175	2500	60		1,461
Aetna Medicare Prime Plan	HMO	H4523-024	150	290	Y		1000	200	2000	45		12,418
Blue Cross Medicare Advantage Basic	HMO	H8133-001	125	295	Y		699/999	Routine	100			1,852
Blue Cross Medicare Advantage Dental Value	HMO	H9706-007	130	275	Y		699/999	Routine	3000	70		71
Blue Cross Medicare Advantage Saver	HMO	H9706-008	100	275	Y		699/999	Routine	100			78
Blue Cross Medicare Advantage Secure	HMO	H9706-005	135	295	Y		699/999	Routine	prevention			304
Devoted Core  001 TX	HMO	H7993-001	150	325	Y		399/699	350	3000	200		2,618
Devoted Core  019 TX	HMO	H7993-019	150	325	Y		399/699	350	3000	100		1,939
Devoted Core GiveBack 006TX	HMO	H7993-006	115	375	Y		0/299	400	250	200	184.7	5,781
HealthSpring True Choice	PPO	H7849-154	115	275	Y		399/1800	100	600	40
HealthSpring Preferred	HMO	H4513-061	150	250	Y	Y	399/1800	300	2550	135		14,801
HealthSpring Preferred Full Saving	HMO	4513-091	115	250	Y		399/1800	150	Copay	40	185	14,606
HealthSpring Preferred Saving	HMO	4513-083	115	250	Y		399/1800	275	Copay	140	130	6,352
HealthSpring Alliance	HMO	4513-064	150	235	Y	Y	399/1800	400	3000	170		5,688
Humana Gold Plus	HMO	H0028-042	150	335	Y	60	699/999	250	2000	50		7,173
Humana Gold Plus	HMO	H0028-072	150	335	Y	60	299/599	350	3000	90		9,022
Humana Total Complete	HMO	H4461-049	150	335	Y	60	299/599	300	3000	90
Humana Gold Plus	HMO	H4461-057	150	335	Y	60	699/999	250	2000	50
Humana Value Choice	PPO	H7617-057	115	335	Y		699/999	150	2000	40
Humana Choice  Giveback	PPO	H5216-358	115	335	Y		699/999	150	1500		89	2,899
KelseyCare Advantage  Freedom	HMO-POS	H0332-004	125	325	Y	10	1500	175	2000	25		5,083
KelseyCare Advantage Signature	HMO	H0332-009	125	275	Y	Y	1500	125	2500	25		23,811
Memorial Hermann  Advantage HMO	HMO	H7115-001	150	250	Y	20	500	500	2500	50		7,512
SCAN Classic	HMO	H8902-005	90	225	Y	54	550	300	3500	100
AARP Medicare Advantage from UHC TX-0009	HMO-POS	H4514-007	130	275			199/829			30		738
AARP Medicare Advantage from UHC tx_001P	HMO-POS	H4514-014	130	275	Y		199/829	200	3000	40		14,541
AARP Medicare Advantage from UHC tx_0015	HMO-POS	H4527-037	130	290	Y		199/829	150	prevention	25		15,198
AARP Medicare Advantage Giveback  UHC TX-31	PPO	H1278-021	115	135	Y		199/829		1500		60	1,474
Verda Noble Care	HMO	H5163-001	90	119	Y	24	299/599	250	Yes	150		641
Wellcare Simple	HMO	H0174-010	150	250	Y		750	300	2000	90		11,442
Wellcare  GiveBack	HMO	H0174-019	115	265	Y		350	100	prevention		105	4,056
Wellcare TexasPlus Classic  Simple	HMO-POS	H4506-003	150	225	Y		750	200	2000	105		14,246
WellPoint  Select	HMO-POS	H8849-009	120	210		Y	3000	300	3250	75		13,529