There are 64 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 (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1080 -043 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 3,604
2014 Formulary |
-- |
|
|
|
2015 AARP MedicareComplete (HMO)
| $0.00 |
$5,900 |
$265 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $9.00 | $45.00 | $45.00 | 3,649 2015 Formulary |
|
2014 AARP MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5287 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2015 AARP MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 AARP MedicareComplete Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
R5287 -001 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 3,604
2014 Formulary |
|
|
|
|
2015 AARP MedicareComplete Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | tbd |
|
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 BlueMedicare HMO LifeTime (HMO)
| $0.00 |
$4,900 |
$0 | Many Generics |
H1026 -040 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,663
2014 Formulary |
|
|
|
|
2015 BlueMedicare HMO LifeTime (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $40.00 | $40.00 | 3,778 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H1026 -056 -0 | | | | | |
|
|
|
|
2015 BlueMedicare HMO MyTime (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,778 2015 Formulary |
|
2014 CareDirect (HMO SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1019 -066 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,696
2014 Formulary |
|
|
|
|
2015 CareDirect (HMO SNP)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,620 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 CareOne PLUS (HMO)
| $0.00 |
$3,400 |
$0 | Some Generics, Few Brands |
H1019 -057 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,696
2014 Formulary |
|
|
|
|
2015 CareOne PLUS (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,617 2015 Formulary |
|
2014 Clear Skies (HMO SNP)
| $0.00 |
n/a |
$0 | All Generics |
H4199 -010 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 2,918
2014 Formulary |
-- |
-- |
|
|
2015 Clear Skies (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | tbd |
|
2014 Day Break (HMO)
| $0.00 |
$3,400 |
$0 | All Generics |
H4199 -008 -0 | $0.00 | $20.00 | $60.00 | $60.00 | 2,918
2014 Formulary |
-- |
-- |
|
|
2015 Day Break (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $45.00 | $95.00 | $95.00 | tbd |
|
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 FHCP Medvantage (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H1035 -007 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
|
|
|
2015 FHCP's Medvantage (HMO-POS)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 Freedom Medicare Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics |
H5427 -060 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom Medicare Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $85.00 | $85.00 | 2,830 2015 Formulary |
|
-- This plan not offered in 2014 --
|
H5427 -089 -0 | | | | | |
-- |
|
|
|
2015 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $75.00 | $75.00 | 2,830 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 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5427 -052 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
|
|
|
2015 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 Freedom VIP Care (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H5427 -070 -0 | $0.00 | $20.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom VIP Care (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $75.00 | $75.00 | 2,830 2015 Formulary |
|
2014 Freedom VIP Savings (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5427 -072 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom VIP Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 2,830 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 Freedom VIP Savings COPD (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5427 -077 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom VIP Savings COPD (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 2,830 2015 Formulary |
|
2014 Humana Gold Plus SNP-DB H1036-193 (HMO SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1036 -193 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,696
2014 Formulary |
|
|
|
|
2015 Humana Gold Plus - Diabetes (HMO SNP)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,620 2015 Formulary |
|
2014 Humana Gold Plus H1036-146 (HMO)
| $0.00 |
$3,400 |
$0 | Some Generics, Few Brands |
H1036 -146 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,696
2014 Formulary |
|
|
|
|
2015 Humana Gold Plus H1036-146 (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,617 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 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$4,000 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2015 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$5,900 |
$150 | Few Generics, Few Brands |
R5826 -074 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,711
2014 Formulary |
|
|
|
|
2015 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $45.00 | $45.00 | tbd |
|
2014 Optimum Diamond Rewards (HMO-POS SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H5594 -030 -0 | $0.00 | $30.00 | $75.00 | $75.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Optimum Diamond Rewards (HMO-POS SNP)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $80.00 | $80.00 | 2,830 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 Optimum Diamond Rewards COPD (HMO-POS SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H5594 -031 -0 | $0.00 | $30.00 | $75.00 | $75.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Optimum Diamond Rewards COPD (HMO-POS SNP)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $80.00 | $80.00 | 2,830 2015 Formulary |
|
2014 Optimum Gold Rewards Plan (HMO-POS)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5594 -022 -0 | $0.00 | $35.00 | $69.00 | $69.00 | 2,770
2014 Formulary |
-- |
|
|
|
2015 Optimum Gold Rewards Plan (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $80.00 | $80.00 | 2,830 2015 Formulary |
|
2014 Preferred Secure Option (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1045 -023 -0 | $6.00 | $45.00 | $95.00 | $95.00 | 3,596
2014 Formulary |
|
|
|
|
2015 Preferred Secure Option (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $45.00 | $95.00 | $95.00 | 3,606 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 Simply Level (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics, Few Brands |
H5471 -042 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,561
2014 Formulary |
|
|
|
|
2015 Simply Level (HMO SNP)
| $0.00 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,635 2015 Formulary |
|
2014 Simply More (HMO)
| $0.00 |
$3,400 |
$0 | Many Generics |
H5471 -043 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,561
2014 Formulary |
|
|
|
|
2015 Simply More (HMO)
| $0.00 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,635 2015 Formulary |
|
2014 Sunrise (HMO)
| $0.00 |
$3,400 |
$0 | All Generics |
H4199 -007 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 2,918
2014 Formulary |
-- |
-- |
|
|
2015 Sunrise (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | tbd |
|
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 WellCare Advance (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1032 -037 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2015 WellCare Advance (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2014 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -179 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $35.00 | $35.00 | 2,947 2015 Formulary |
|
2014 WellCare Essential (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -173 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Essential (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $25.00 | $25.00 | 2,947 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 WellCare Value (HMO-POS)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -091 -0 | $0.00 | $10.00 | $25.00 | $25.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Value (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $25.00 | $25.00 | 2,947 2015 Formulary |
|
2014 FHCP Medvantage Rx (HMO)
| $0.00 |
$4,500 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H1035 -006 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 1,993
2014 Formulary |
-- |
|
|
|
2015 FHCP's Medvantage Rx (HMO)
| $12.00 |
$6,700 |
$160 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $40.00 | $40.00 | 2,086 2015 Formulary |
|
2014 WellCare Liberty (HMO SNP)
| $9.40 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1032 -124 -0 | $0.00 | $4.00 | $35.00 | $35.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Access (HMO SNP)
| $17.70 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,946 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 WellCare Access (HMO SNP)
| $10.40 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1032 -175 -0 | $0.00 | $7.00 | $35.00 | $35.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Liberty (HMO SNP)
| $18.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,946 2015 Formulary |
|
2014 CareNeeds (HMO SNP)
| $16.30 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1019 -028 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,696
2014 Formulary |
|
|
|
|
2015 CareNeeds (HMO SNP)
| $19.20 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,617 2015 Formulary |
|
2014 WellCare Select (HMO SNP)
| $11.60 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1032 -061 -0 | $0.00 | $4.00 | $35.00 | $35.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Select (HMO SNP)
| $19.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,946 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 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $19.80 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5417 -001 -0 | 25% | 25% | 25% | 25% | 3,604
2014 Formulary |
-- |
-- |
|
|
2015 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $24.30 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,649 2015 Formulary |
|
2014 Humana Gold Plus SNP-DE H1036-213 (HMO SNP)
| $15.40 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1036 -213 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,696
2014 Formulary |
|
|
|
|
2015 Humana Gold Plus SNP-DE H1036-213 (HMO SNP)
| $24.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,617 2015 Formulary |
|
2014 Freedom Medi-Medi Full (HMO SNP)
| $22.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | 0% | | | | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom Medi-Medi Full (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,828 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 Freedom Medi-Medi Partial (HMO SNP)
| $22.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | 15% | | | | 2,770
2014 Formulary |
-- |
|
|
|
2015 Freedom Medi-Medi Partial (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,828 2015 Formulary |
|
2014 Optimum Emerald Full (HMO SNP)
| $22.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | 0% | | | | 2,770
2014 Formulary |
-- |
|
|
|
2015 Optimum Emerald Full (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,830 2015 Formulary |
|
2014 Optimum Emerald Partial (HMO SNP)
| $22.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | 15% | | | | 2,770
2014 Formulary |
-- |
|
|
|
2015 Optimum Emerald Partial (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,830 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 Simply Complete (HMO SNP)
| $22.10 |
n/a |
$310 | Many Generics |
H5471 -039 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,561
2014 Formulary |
|
|
|
|
2015 Simply Complete (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,635 2015 Formulary |
|
2014 Sunny Days (HMO SNP)
| $3.60 |
n/a |
$0 | All Generics |
H4199 -011 -0 | $0.00 | 25% | 25% | 25% | 2,918
2014 Formulary |
-- |
-- |
|
|
2015 Sunny Days (HMO SNP)
| $25.80 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | tbd |
|
2014 Advantage by Sunshine Health (HMO SNP)
| $21.00 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5190 -001 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,966
2014 Formulary |
-- |
-- |
-- |
|
2015 Sunshine Health Advantage (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 2,999 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 UnitedHealthcare Dual Complete RP (Regional PPO SNP)
| $21.80 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
R5287 -003 -0 | 15% | 15% | 15% | 15% | 3,604
2014 Formulary |
|
|
|
|
2015 UnitedHealthcare Dual Complete RP (Regional PPO SNP)
| $25.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
|
2014 BlueMedicare Regional PPO (Regional PPO)
| $0.00 |
$6,700 |
$30 | No additional gap coverage, only the Donut Hole Discount |
R3332 -001 -0 | $10.00 | $33.00 | $45.00 | $45.00 | 3,663
2014 Formulary |
|
|
|
|
2015 BlueMedicare Regional PPO (Regional PPO)
| $36.10 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $28.00 | $40.00 | $40.00 | tbd |
|
2014 FHCP Medvantage Rx Plus (HMO-POS)
| $24.00 |
$2,900 |
$0 | Many Generics |
H1035 -002 -0 | $0.00 | $4.00 | 25% | 25% | 1,993
2014 Formulary |
-- |
|
|
|
2015 FHCP's Medvantage Rx Plus (HMO-POS)
| $46.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | 25% | 25% | 2,086 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 WellCare Choice (HMO-POS)
| $46.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -002 -0 | $0.00 | $10.00 | $25.00 | $25.00 | 2,844
2014 Formulary |
|
|
|
|
2015 WellCare Choice (HMO-POS)
| $46.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $25.00 | $25.00 | 2,947 2015 Formulary |
|
2014 HumanaChoice R5826-005 (Regional PPO)
| $92.00 |
$5,700 |
$0 | Few Generics, Few Brands |
R5826 -005 -0 | $3.00 | $8.00 | $40.00 | $40.00 | 3,711
2014 Formulary |
|
|
|
|
2015 HumanaChoice R5826-005 (Regional PPO)
| $95.00 |
$6,700 |
$100 | Yes, some additional gap coverage. | $3.00 | $8.00 | $40.00 | $40.00 | tbd |
|
2014 Humana Gold Choice H8145-061 (PFFS)
| $103.00 |
n/a |
$0 | Few Generics, Few Brands |
H8145 -061 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,711
2014 Formulary |
|
|
|
|
2015 Humana Gold Choice H8145-061 (PFFS)
| $101.00 |
n/a |
$0 | Yes, some additional gap coverage. | $6.00 | $15.00 | $45.00 | $45.00 | 3,630 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 --
|
H5434 -002 -0 | | | | | |
|
|
|
|
2015 BlueMedicare PPO (PPO)
| $127.10 |
$3,200 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $30.00 | $30.00 | 3,778 2015 Formulary |
|
2014 BlueMedicare HMO PrimeTime (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1026 -054 -0 | $2.00 | $5.00 | $40.00 | $40.00 | 3,663
2014 Formulary |
|
|
|
|
-- Members will be assigned to BlueMedicare HMO LifeTime (HMO) H1026-040 --
| | | | | |
|
2014 CareNeeds PLUS (HMO SNP)
| $12.20 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1019 -049 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,696
2014 Formulary |
|
|
|
|
-- Members will be assigned to CareNeeds (HMO SNP) H1019-028 --
| | | | | |
|
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 Freedom Savings Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5427 -054 -0 | $0.00 | $35.00 | $90.00 | $90.00 | 2,770
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Freedom Medicare Plan Rx (HMO) H5427-060 --
| | | | | |
|
2014 Freedom VIP Care COPD (HMO SNP)
| $0.00 |
n/a |
$0 | Many Generics |
H5427 -076 -0 | $0.00 | $20.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Freedom VIP Savings COPD (HMO SNP) H5427-077 --
| | | | | |
|
2014 Humana Gold Plus SNP-DE H1036-159 (HMO SNP)
| $19.80 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H1036 -159 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,696
2014 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus SNP-DE H1036-213 (HMO SNP) H1036-213 --
| | | | | |
|
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 Optimum Platinum Plan (HMO-POS)
| $0.00 |
$3,400 |
$0 | Many Generics |
H5594 -033 -0 | $0.00 | $25.00 | $80.00 | $80.00 | 2,770
2014 Formulary |
-- |
|
|
|
-- Members will be assigned to Optimum Gold Rewards Plan (HMO-POS) H5594-022 --
| | | | | |
|
2014 PUP REWARDS (HMO)
| $0.00 |
$4,300 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5696 -004 -0 | $0.00 | $35.00 | $95.00 | $95.00 | 3,267
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
2014 PUP EXTRA (HMO SNP)
| $9.90 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5696 -021 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,267
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
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 PUP PLUS (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5696 -034 -0 | $3.00 | $35.00 | $95.00 | $95.00 | 3,267
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
2014 PUP SIMPLE (HMO)
| $0.00 |
$4,200 |
$0 | Many Generics |
H5696 -033 -0 | $0.00 | $25.00 | $85.00 | $85.00 | 3,267
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
2014 Day Light (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H4199 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
-- |
|
|
-- This plan not offered in 2015 --
|
| | | | |
|
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 Simply Extra (HMO)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5471 -044 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 3,561
2014 Formulary |
|
|
|
|
-- This plan not offered in 2015 --
|
| | | | |
|