There are 68 Medicare Advantage plans meeting your criteria.
2014 / 2015 Medicare Advantage Plan Information
Click here to jump to the Chart Legend |
Plan Name |
Monthly Premium |
Part A&B Maximum Out-Of Pocket |
Part D Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Formulary Drugs |
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
No Rx Coverage |
H0543 -121 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2015 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,400 |
$0 | Some Generics |
H0543 -138 -0 | $0.00 | $7.00 | $45.00 | $45.00 | 3,604
2014 Formulary |
|
|
|
|
2015 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $45.00 | $45.00 | 3,649 2015 Formulary |
|
2014 AARP MedicareComplete SecureHorizons Premier (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0543 -004 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 3,604
2014 Formulary |
|
|
|
|
2015 AARP MedicareComplete SecureHorizons Premier (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $45.00 | $45.00 | 3,649 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Aetna Medicare Value Plan (HMO)
| $0.00 |
$2,000 |
$0 | Many Generics |
H0523 -060 -0 | $5.00 | 25% | 50% | 50% | 2,800
2014 Formulary |
-- |
|
|
|
2015 Aetna Medicare Prime Plan (HMO)
| $0.00 |
$1,950 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $45.00 | $45.00 | 2,816 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0564 -063 -0 | | | | | |
-- |
|
|
|
2015 Anthem Select Advantage (HMO)
| $0.00 |
$3,400 |
$120 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $19.00 | $40.00 | $40.00 | 3,016 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0564 -068 -0 | | | | | |
-- |
|
|
|
2015 Blue Cross Senior Secure Plan I (HMO)
| $0.00 |
$6,000 |
$50 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $28.00 | $40.00 | $40.00 | 3,016 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Blue Shield 65 Plus (HMO)
| $0.00 |
$2,800 |
$0 | Many Generics |
H0504 -015 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,231
2014 Formulary |
|
|
|
|
2015 Blue Shield 65 Plus (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,397 2015 Formulary |
|
2014 Blue Shield 65 Plus Choice Plan (HMO)
| $0.00 |
$2,000 |
$0 | Many Generics |
H0504 -021 -0 | $0.00 | $35.00 | $70.00 | $70.00 | 3,231
2014 Formulary |
|
|
|
|
2015 Blue Shield 65 Plus Choice Plan (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $30.00 | $30.00 | 3,397 2015 Formulary |
|
2014 Brand New Day Dementia with Enhanced Drug Benefits (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H0838 -028 -0 | $3.00 | $9.00 | $45.00 | $45.00 | 3,193
2014 Formulary |
-- |
|
|
|
2015 Bridges Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,161 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Care1st AdvantageOptimum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics |
H5928 -004 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,743
2014 Formulary |
|
|
|
|
2015 Care1st AdvantageOptimum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 2,838 2015 Formulary |
|
2014 CareMore Breathe (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0544 -014 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore Breathe (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
2014 CareMore ESRD (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0544 -015 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore ESRD (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 CareMore Heart (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0544 -013 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore Heart (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
2014 CareMore Reliance (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0544 -004 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore Reliance (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
2014 CareMore StartSmart Plus (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0544 -007 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore StartSmart Plus (HMO)
| $0.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.50 | $45.00 | $45.00 | 2,834 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 CareMore Touch (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0544 -005 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore Touch (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
2014 CareMore Value Plus (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics, Few Brands |
H0544 -002 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,751
2014 Formulary |
-- |
|
|
|
2015 CareMore Value Plus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,834 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H5649 -005 -0 | | | | | |
|
|
|
|
2015 Central Health Focus Plan (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $25.00 | $25.00 | 2,803 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Central Health Medicare Plan (HMO)
| $0.00 |
$3,400 |
$0 | All Generics |
H5649 -001 -0 | $0.00 | $5.00 | $25.00 | $25.00 | 2,870
2014 Formulary |
|
|
|
|
2015 Central Health Medicare Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $25.00 | $25.00 | 2,803 2015 Formulary |
|
2014 Citizens Choice Healthplan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3815 -001 -0 | $5.00 | $30.00 | $75.00 | $75.00 | 2,987
2014 Formulary |
-- |
|
|
|
2015 Citizens Choice Health Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $5.00 | $30.00 | $30.00 | 3,096 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0838 -025 -0 | | | | | |
-- |
|
|
|
2015 Classic Care (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,161 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Easy Choice Best Plan (HMO)
| $0.00 |
$6,700 |
$0 | Many Generics |
H5087 -005 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,267
2014 Formulary |
-- |
|
|
|
2015 Easy Choice Best Plan (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $39.00 | $39.00 | 3,445 2015 Formulary |
|
2014 Health Net Gold Select (HMO)
| $0.00 |
$2,200 |
$0 | Many Generics, Few Brands |
H0562 -101 -1 | $0.00 | $10.00 | $45.00 | $45.00 | 4,195
2014 Formulary |
|
|
|
|
2015 Health Net Gold Select (HMO)
| $0.00 |
$2,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,810 2015 Formulary |
|
2014 Health Net Healthy Heart (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics, Few Brands |
H0562 -100 -1 | $4.00 | $10.00 | $45.00 | $45.00 | 4,195
2014 Formulary |
|
|
|
|
2015 Health Net Healthy Heart (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $35.00 | $35.00 | 3,780 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Health Net Jade (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H0562 -092 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 4,187
2014 Formulary |
|
|
|
|
2015 Health Net Jade (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,810 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0838 -030 -0 | | | | | |
-- |
|
|
|
2015 Healthy Heart Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,161 2015 Formulary |
|
2014 Heart First (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H5425 -028 -0 | $3.00 | $7.00 | $40.00 | $40.00 | 2,747
2014 Formulary |
|
|
|
|
2015 Heart First (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $45.00 | $45.00 | 2,862 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2014 --
|
H0838 -032 -0 | | | | | |
-- |
|
|
|
2015 Hope Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $45.00 | $45.00 | 3,161 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0108 -011 -0 | | | | | |
-- |
|
|
|
2015 Humana Gold Plus H0108-011 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $30.00 | $30.00 | 3,617 2015 Formulary |
|
2014 Brand New Day Diabetes with Enhanced Drug Benefits (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H0838 -026 -0 | $3.00 | $9.00 | $45.00 | $45.00 | 3,193
2014 Formulary |
-- |
|
|
|
2015 In Control Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $45.00 | $45.00 | 3,161 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Inter Valley Health Plan OC Preferred (HMO)
| $0.00 |
$3,400 |
$0 | Some Generics |
H0545 -013 -0 | $5.00 | $15.00 | $39.00 | $39.00 | 2,710
2014 Formulary |
-- |
|
|
|
2015 Inter Valley Health Plan OC Preferred (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $39.00 | $39.00 | 2,761 2015 Formulary |
|
2014 Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
| $0.00 |
$5,900 |
$0 | All Generics, Few Brands |
H0524 -003 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 5,237
2014 Formulary |
|
|
|
|
2015 Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $45.00 | $45.00 | 5,467 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H3815 -008 -0 | | | | | |
-- |
|
|
|
2015 Platinum Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $30.00 | $30.00 | 3,096 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 SCAN Balance (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H5425 -034 -0 | $3.00 | $7.00 | $40.00 | $40.00 | 2,747
2014 Formulary |
|
|
|
|
2015 SCAN Balance (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $45.00 | $45.00 | 2,862 2015 Formulary |
|
2014 SCAN Classic (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics |
H5425 -007 -0 | $5.00 | $10.00 | $40.00 | $40.00 | 2,747
2014 Formulary |
|
|
|
|
2015 SCAN Classic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $5.00 | $10.00 | $45.00 | $45.00 | 2,862 2015 Formulary |
|
2014 SCAN Healthy at Home (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H9104 -006 -0 | $3.00 | $10.00 | $39.00 | $39.00 | 2,747
2014 Formulary |
-- |
|
|
|
2015 SCAN Healthy at Home (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $45.00 | $45.00 | 2,862 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
| $14.40 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0524 -029 -0 | $7.00 | $12.00 | $45.00 | $45.00 | 5,237
2014 Formulary |
|
|
|
|
2015 Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
| $15.30 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 5,467 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0108 -050 -0 | | | | | |
-- |
|
|
|
2015 Humana Gold Plus H0108-050 (HMO)
| $22.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $45.00 | $45.00 | 3,630 2015 Formulary |
|
2014 Care1st TotalDual Plan (HMO SNP)
| $21.90 |
n/a |
$310 | Few Generics |
H5928 -005 -0 | $0.00 | 25% | 25% | 25% | 2,743
2014 Formulary |
|
|
|
|
2015 Care1st TotalDual Plan (HMO SNP)
| $27.50 |
$1 |
$320 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 2,838 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Aetna Medicare Select Plan (HMO)
| $0.00 |
$6,700 |
$0 | Few Generics |
H0523 -002 -0 | $10.00 | 25% | 50% | 50% | 3,134
2014 Formulary |
-- |
|
|
|
2015 Aetna Medicare Select Plan (HMO)
| $28.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $45.00 | $45.00 | 2,816 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0108 -047 -0 | | | | | |
-- |
|
|
|
2015 Humana Gold Plus H0108-047 (HMO)
| $28.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $2.00 | $30.00 | $30.00 | 3,617 2015 Formulary |
|
2014 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $16.20 |
$6,700 |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0543 -153 -0 | 25% | 25% | 25% | 25% | 3,604
2014 Formulary |
|
|
|
|
2015 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,649 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Brand New Day Dementia with Extra Care (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0838 -029 -0 | 25% | 25% | 25% | 25% | 3,193
2014 Formulary |
-- |
|
|
|
2015 Bridges Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 25% | 25% | 25% | 3,161 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H3815 -009 -0 | | | | | |
-- |
|
|
|
2015 CalPlus Plan (HMO)
| $28.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,096 2015 Formulary |
|
2014 Central Health Premier Plan (HMO)
| $28.10 |
$6,700 |
$310 | Many Generics |
H5649 -004 -0 | $0.00 | $0.00 | 25% | 25% | 2,870
2014 Formulary |
|
|
|
|
2015 Central Health Premier Plan (HMO)
| $28.80 |
$6,700 |
$320 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 2,803 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Coordinated Choice Plan (HMO)
| $26.30 |
$3,400 |
$310 | Few Generics |
H5928 -037 -0 | $0.00 | 25% | 25% | 25% | 2,743
2014 Formulary |
|
|
|
|
2015 Coordinated Choice Plan (HMO)
| $28.80 |
$6,700 |
$320 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 2,838 2015 Formulary |
|
2014 Brand New Day Dual Coverage (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0838 -024 -0 | 15% | 15% | 15% | 15% | 3,193
2014 Formulary |
-- |
|
|
|
2015 Dual Coverage (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,161 2015 Formulary |
|
2014 Easy Choice Plus Plan (HMO)
| $28.10 |
$6,700 |
$310 | Call plan for details |
H5087 -002 -0 | $0.00 | 25% | 25% | 25% | 3,267
2014 Formulary |
-- |
|
|
|
2015 Easy Choice Plus Plan (HMO)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $29.00 | $40.00 | $40.00 | 3,445 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Brand New Day for Mental Illness (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0838 -020 -0 | 25% | 25% | 25% | 25% | 3,193
2014 Formulary |
-- |
|
|
|
2015 Harmony (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,161 2015 Formulary |
|
2014 Health Net Seniority Plus Amber I (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0562 -055 -0 | $0.00 | $12.00 | $41.00 | $41.00 | 4,195
2014 Formulary |
|
|
|
|
2015 Health Net Seniority Plus Amber I (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,810 2015 Formulary |
|
2014 Health Net Seniority Plus Amber II (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0562 -070 -0 | $0.00 | $13.00 | $45.00 | $45.00 | 4,195
2014 Formulary |
|
|
|
|
2015 Health Net Seniority Plus Amber II (HMO SNP)
| $28.80 |
$825 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,810 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2014 --
|
H0562 -104 -0 | | | | | |
|
|
|
|
2015 Health Net Seniority Plus Sapphire (HMO)
| $28.80 |
$5,900 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $30.00 | $45.00 | $45.00 | 3,810 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0838 -031 -0 | | | | | |
-- |
|
|
|
2015 Healthy Heart Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 25% | 25% | 25% | 3,161 2015 Formulary |
|
2014 Brand New Day Diabetes with Extra Care (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0838 -027 -0 | 25% | 25% | 25% | 25% | 3,193
2014 Formulary |
-- |
|
|
|
2015 In Control Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 25% | 25% | 25% | 3,161 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 SCAN Plus (HMO)
| $24.90 |
$6,700 |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5425 -037 -0 | 25% | 25% | 25% | 25% | 2,747
2014 Formulary |
|
|
|
|
2015 SCAN Plus (HMO)
| $28.80 |
$6,000 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,862 2015 Formulary |
|
2014 VillageHealth (HMO SNP)
| $28.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5943 -002 -0 | 25% | 25% | 25% | 25% | 2,747
2014 Formulary |
-- |
|
|
|
2015 VillageHealth (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,862 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H5521 -056 -0 | | | | | |
|
|
|
|
2015 Aetna Medicare Choice Plan (PPO)
| $108.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $45.00 | $45.00 | 2,816 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2014 --
|
H8552 -020 -0 | | | | | |
|
|
|
|
2015 Anthem Medicare Preferred Standard (PPO)
| $130.00 |
$6,700 |
$210 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $22.00 | $40.00 | $40.00 | 3,016 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H5521 -052 -0 | | | | | |
|
|
|
|
2015 Aetna Medicare Select Plus Plan (PPO)
| $139.00 |
$3,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $45.00 | $45.00 | 3,112 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H0562 -106 -0 | | | | | |
|
|
|
|
2015 Health Net Seniority Plus Complete (HMO)
| $176.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $45.00 | $45.00 | 3,810 2015 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Anthem Medicare Preferred Standard (PPO)
| $100.00 |
$4,500 |
$135 | No additional gap coverage, only the Donut Hole Discount |
H8552 -002 -0 | $5.00 | $17.00 | $40.00 | $40.00 | 2,880
2014 Formulary |
|
|
|
|
-- Members will be assigned to Anthem Medicare Preferred Standard (PPO) H8552-020 --
| | | | | |
|
2014 Blue Cross Senior Secure Plan I (HMO)
| $0.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0564 -006 -0 | $5.00 | $14.00 | $40.00 | $40.00 | 2,880
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Blue Cross Senior Secure Plan I (HMO) H0564-068 --
| | | | | |
|
2014 Brand New Day Enhanced Drug Savings for So Cal (HMO)
| $0.00 |
$6,700 |
$0 | Many Generics |
H0838 -022 -0 | $3.00 | $9.00 | $45.00 | $45.00 | 3,193
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Classic Care (HMO) H0838-025 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 Brand New Day Extra Care (HMO)
| $28.10 |
$6,700 |
$310 | No additional gap coverage, only the Donut Hole Discount |
H0838 -023 -0 | 25% | 25% | 25% | 25% | 3,193
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Classic Care (HMO) H0838-025 --
| | | | | |
|
2014 Golden State Medicare Health Plan, Golden (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics, Few Brands |
H2241 -001 -0 | $4.00 | $40.00 | $80.00 | $80.00 | 5,147
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Golden State Medicare Health Plan, Golden (HMO) H2241-003 --
| | | | | |
|
2014 Humana Gold Plus H0108-013 (HMO)
| $0.00 |
$3,400 |
$0 | Some Generics, Few Brands |
H0108 -013 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,711
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Humana Gold Plus H0108-011 (HMO) H0108-011 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2014 OneCare (HMO SNP)
| $26.10 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5433 -001 -0 | $0.00 | $0.00 | | | 3,164
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
2014 Health Net Seniority Plus Ruby (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics, Few Brands |
H0562 -099 -1 | $4.00 | $10.00 | $45.00 | $45.00 | 4,195
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|