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2013 Medicare Advantage Plan Prescription Drug Cost-Sharing Details
| 2013 Medicare Advantage Prescription Drug Formulary (Drug List) Cost-Sharing Details | ||||||
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HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS) (H2354-001-0) Benefit Details 
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| This plan is available in ISABELLA County, MI Click on a letter below to view the HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS) Formulary A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 0-9 | ||||||
| 30-Day Supply Cost-Sharing |
90-Day Supply Cost-Sharing |
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| Preferred Pharmacy | Standard Pharmacy | Mail- Order* | Preferred Pharmacy | Standard Pharmacy | Mail- Order* | |
| This plan does not have an Initial Deductible: | n/a | n/a | n/a | n/a | n/a | n/a |
| Initial Coverage Phase Cost-Sharing | ||||||
| Tier 1: Generic: | $7.00 | $7.00 | $7.00 | $14.00 | $14.00 | $14.00 |
| Tier 2: Preferred Brand: | $39.00 | $39.00 | $39.00 | $78.00 | $78.00 | $78.00 |
| Tier 3: Non-Preferred Brand: | $74.00 | $74.00 | $74.00 | $148.00 | $148.00 | $148.00 |
| Tier 4: Specialty Tier: | 25% | 25% | 25% | 25% | 25% | 25% |
| Coverage Gap (Donut Hole) Phase Cost Sharing Plan offers no Gap Coverage -- 21% Generic and 52.5% Brand Donut Hole Discount applies | ||||||
| All Formulary Generic Drugs: | 79% | 79% | 79% | 79% | 79% | 79% |
| All Formulary Brand-Name Drugs: | 47.5% | 47.5% | 47.5% | 47.5% | 47.5% | 47.5% |
| Catastrophic Coverage Phase Cost Sharing | ||||||
| Generic & Preferred Multi-Source Drugs: | The greater of 5% or $2.65 | The greater of 5% or $2.65 | ||||
| Other Drugs (Brand-Name or Non-Preferred Multi-Source Drugs): | The greater of 5% or $6.60 | The greater of 5% or $6.60 | ||||
| Go to the HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS) 2013 Formulary Browser by choosing a letter below: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z 0-9 | ||||||