2010 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | Medica Prime Solution Enhanced w/Std. Rx - MN (Cost) | ||||
Location: | Swift, Minnesota Click to see other locations | ||||
Plan ID: | H2450 - 002 - 0 Click to see other plans | ||||
Member Services: | |||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the Medica Prime Solution Enhanced w/Std. Rx - MN (Cost) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $158.90 | ||||
Annual Rx Deductible: | $0 | ||||
Annual Rx Initial Coverage Limit (ICL): | $2,830 | ||||
Health Plan Type: | Cost | ||||
Rx Gap Coverage? | No Gap Coverage | ||||
Total Number of Formulary Drugs: | 4,845 drugs | Browse the Medica Prime Solution Enhanced w/Std. Rx - MN (Cost) Formulary | |||
This plan has 4 drug tiers. See cost-sharing highlights below. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $10.00 | $34.00 | $74.00 | 25% | |
• Number of Drugs per Tier: | 1935 | 881 | 1829 | 200 | |
Number of Members enrolled in this plan in (H2450 - 002): | 17,971 members |