There are 83 Medicare Advantage plans meeting your criteria.
2015 / 2016 Medicare Advantage Plan Information
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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 |
2015 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
No Rx Coverage |
H0543 -121 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2015 AARP MedicareComplete SecureHorizons Plan 1 (HMO)
| $0.00 |
$5,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0543 -001 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
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2016 AARP MedicareComplete SecureHorizons Plan 1 (HMO)
| $0.00 |
$5,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
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2015 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0543 -151 -0 | $0.00 | $7.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
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2016 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
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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 |
2015 Aetna Medicare Prime Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0523 -061 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 2,816
2015 Formulary |
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2016 Aetna Medicare Prime Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,279 2016 Formulary |
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2015 Blue Cross Senior Secure Plan I (HMO)
| $0.00 |
$6,000 |
$50 | No additional gap coverage, only the Donut Hole Discount |
H0564 -068 -0 | $5.00 | $28.00 | $40.00 | $40.00 | 3,016
2015 Formulary |
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-- |
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2016 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
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2015 Anthem Select Advantage (HMO)
| $0.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H0564 -062 -0 | $5.00 | $21.00 | $40.00 | $40.00 | 3,016
2015 Formulary |
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-- |
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2016 Anthem MediBlue Select (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $4.00 | $12.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
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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 |
2015 Blue Shield 65 Plus (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. |
H0504 -015 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,397
2015 Formulary |
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2016 Blue Shield 65 Plus (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,553 2016 Formulary |
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2015 Blue Shield 65 Plus Choice Plan (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H0504 -021 -0 | $0.00 | $3.00 | $30.00 | $30.00 | n/a |
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2016 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 | tbd |
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2015 Bridges Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0838 -028 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,161
2015 Formulary |
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-- |
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2016 Bridges Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,222 2016 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 |
2015 Care1st AdvantageOptimum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5928 -004 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 2,838
2015 Formulary |
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2016 Care1st AdvantageOptimum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 2,979 2016 Formulary |
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2015 Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0148 -002 -0 | $0.00 | $0.00 | $0.00 | | 2,838
2015 Formulary |
new |
new |
new |
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2016 Care1st Cal MediConnect Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 2,979 2016 Formulary |
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2015 CareMore Breathe (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -014 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore Breathe (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 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 |
2015 CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6229 -005 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,807
2015 Formulary |
new |
new |
new |
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2016 CareMore Cal MediConnect Medicare-Medicaid Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 2,956 2016 Formulary |
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2015 CareMore Connect (HMO SNP)
| $0.00 |
n/a |
$320 | Yes, some additional gap coverage. |
H0544 -003 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,834
2015 Formulary |
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2016 CareMore Connect (HMO SNP)
| $0.00 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 2,970 2016 Formulary |
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2015 CareMore ESRD (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -015 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore ESRD (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 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 |
2015 CareMore Heart (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -013 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore Heart (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 Formulary |
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2015 CareMore Reliance (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -004 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore Reliance (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 Formulary |
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2015 CareMore StartSmart Plus (HMO)
| $0.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0544 -007 -0 | $5.00 | $12.50 | $45.00 | $45.00 | 2,834
2015 Formulary |
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2016 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 | 2,970 2016 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 |
2015 CareMore Touch (HMO SNP)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -005 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore Touch (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 Formulary |
|
2015 CareMore Value Plus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0544 -002 -0 | $0.00 | $7.50 | $37.50 | $37.50 | 2,834
2015 Formulary |
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2016 CareMore Value Plus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $37.50 | $37.50 | 2,970 2016 Formulary |
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-- This plan not offered in 2015 --
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H5649 -006 -0 | | | | | |
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2016 Central Health Focus Plan (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 2,758 2016 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 |
2015 Central Health Medicare Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5649 -001 -0 | $0.00 | $5.00 | $25.00 | $25.00 | 2,803
2015 Formulary |
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2016 Central Health Medicare Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 2,758 2016 Formulary |
|
2015 Classic Care (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H0838 -025 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,161
2015 Formulary |
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-- |
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2016 Classic Care (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,222 2016 Formulary |
|
2015 Easy Choice Best Plan (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5087 -005 -0 | $0.00 | $10.00 | $39.00 | $39.00 | 3,445
2015 Formulary |
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2016 Easy Choice Best Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 4,065 2016 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 2015 --
|
H2241 -006 -0 | | | | | |
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2016 Golden State Medicare Health Plan, Golden (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $5.00 | $10.00 | $45.00 | $45.00 | 3,969 2016 Formulary |
|
2015 Health Net Cal MediConnect (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3237 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,010
2015 Formulary |
new |
new |
new |
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2016 Health Net Cal MediConnect Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,300 2016 Formulary |
|
2015 Health Net Gold Select (HMO)
| $0.00 |
$2,200 |
$0 | Yes, some additional gap coverage. |
H0562 -101 -1 | $0.00 | $10.00 | $45.00 | $45.00 | 3,810
2015 Formulary |
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2016 Health Net Gold Select (HMO)
| $0.00 |
$2,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 4,057 2016 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 |
2015 Health Net Jade (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0562 -092 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,810
2015 Formulary |
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2016 Health Net Jade (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 4,057 2016 Formulary |
|
2015 Health Net Seniority Plus Green (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H0562 -044 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 Health Net Seniority Plus Green (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Healthy Heart Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0838 -030 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,161
2015 Formulary |
|
-- |
|
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2016 Healthy Heart Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,222 2016 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 2015 --
|
H3815 -010 -0 | | | | | |
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2016 Heart & Diabetes (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,200 2016 Formulary |
|
2015 Hope Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0838 -032 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,161
2015 Formulary |
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-- |
|
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2016 Hope Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $45.00 | $45.00 | 3,222 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5619 -021 -0 | | | | | |
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2016 Humana Gold Plus H5619-021 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,607 2016 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 |
2015 In Control Drug Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0838 -026 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,161
2015 Formulary |
|
-- |
|
|
2016 In Control Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $45.00 | $45.00 | 3,222 2016 Formulary |
|
2015 Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. |
H0524 -003 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 5,467
2015 Formulary |
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|
|
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2016 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 | 5,780 2016 Formulary |
|
2015 L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8258 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,499
2015 Formulary |
new |
new |
new |
|
2016 L.A Care Cal MediConnect Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,678 2016 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 |
2015 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8677 -002 -0 | $0.00 | $0.00 | $0.00 | | 2,895
2015 Formulary |
new |
new |
new |
|
2016 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,041 2016 Formulary |
|
2015 Citizens Choice Health Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3815 -001 -0 | $3.00 | $5.00 | $30.00 | $30.00 | 3,096
2015 Formulary |
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|
|
|
2016 My Choice Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $5.00 | $30.00 | $30.00 | 3,200 2016 Formulary |
|
2015 PHP (HMO SNP)
| $0.00 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5852 -001 -0 | 25% | 25% | 25% | | 2,649
2015 Formulary |
|
|
|
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2016 PHP (HMO SNP)
| $0.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,222 2016 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 |
2015 Platinum Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3815 -008 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,096
2015 Formulary |
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|
|
|
2016 Platinum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,200 2016 Formulary |
|
2015 SCAN Balance (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5425 -034 -0 | $3.00 | $7.00 | $45.00 | $45.00 | 2,862
2015 Formulary |
|
|
|
|
2016 SCAN Balance (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $47.00 | $47.00 | 3,048 2016 Formulary |
|
2015 SCAN Classic (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H5425 -006 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 2,862
2015 Formulary |
|
|
|
|
2016 SCAN Classic (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,048 2016 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 |
2015 SCAN Healthy at Home (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H9104 -006 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 2,862
2015 Formulary |
|
-- |
|
|
2016 SCAN Healthy at Home (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,048 2016 Formulary |
|
2015 Easy Choice Freedom Plan (HMO SNP)
| $23.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5087 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,445
2015 Formulary |
|
|
|
|
2016 Easy Choice Freedom Plan (HMO SNP)
| $8.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 2,801 2016 Formulary |
|
2015 Easy Choice Plus Plan (HMO)
| $23.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5087 -017 -0 | $0.00 | $29.00 | $40.00 | $40.00 | 3,445
2015 Formulary |
|
|
|
|
2016 Easy Choice Plus Plan (HMO)
| $12.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,065 2016 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 |
2015 Molina Medicare Options Plus (HMO SNP)
| $21.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5810 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,895
2015 Formulary |
|
|
|
|
2016 Molina Medicare Options Plus (HMO SNP)
| $18.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,041 2016 Formulary |
|
2015 Health Net Healthy Heart (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0562 -100 -1 | $3.00 | $10.00 | $35.00 | $35.00 | 3,780
2015 Formulary |
|
|
|
|
2016 Health Net Healthy Heart (HMO)
| $20.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $5.00 | $10.00 | $37.00 | $37.00 | 4,057 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0544 -049 -0 | | | | | |
|
|
|
|
2016 CareMore Connect Plus (HMO)
| $22.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,970 2016 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 2015 --
|
H5619 -037 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus H5619-037 (HMO)
| $23.40 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $47.00 | $47.00 | 3,615 2016 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 |
H0524 -029 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 5,467
2015 Formulary |
|
|
|
|
2016 Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
| $25.20 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $17.00 | $47.00 | $47.00 | 5,780 2016 Formulary |
|
2015 Aetna Medicare Select Plan (HMO)
| $28.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0523 -002 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 2,816
2015 Formulary |
|
|
|
|
2016 Aetna Medicare Select Plan (HMO)
| $27.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,279 2016 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 |
2015 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0543 -153 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
2016 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $27.40 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0564 -080 -0 | | | | | |
|
-- |
|
|
2016 Anthem MediBlue Coordination Plus (HMO)
| $31.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,266 2016 Formulary |
|
2015 Bridges Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0838 -029 -0 | $0.00 | 25% | 25% | 25% | 3,161
2015 Formulary |
|
-- |
|
|
2016 Bridges - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,222 2016 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 |
2015 CalPlus Plan (HMO)
| $28.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3815 -009 -0 | | | | | 3,096
2015 Formulary |
|
|
|
|
2016 CalPlus Plan (HMO)
| $31.00 |
$3,400 |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,200 2016 Formulary |
|
2015 Care1st TotalDual Plan (HMO SNP)
| $27.00 |
$1 |
$320 | Yes, some additional gap coverage. |
H5928 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,838
2015 Formulary |
|
|
|
|
2016 Care1st TotalDual Plan (HMO SNP)
| $31.00 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 2,979 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0838 -033 -0 | | | | | |
|
-- |
|
|
2016 Classic Choice for Medi-Medi (HMO)
| $31.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,222 2016 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 |
2015 Coordinated Choice Plan (HMO)
| $28.80 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H5928 -037 -0 | $0.00 | 25% | 25% | 25% | 2,838
2015 Formulary |
|
|
|
|
2016 Coordinated Choice Plan (HMO)
| $31.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 2,979 2016 Formulary |
|
2015 Dual Coverage (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0838 -024 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,161
2015 Formulary |
|
-- |
|
|
2016 Dual Coverage (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | 25% | 25% | 3,222 2016 Formulary |
|
2015 Harmony (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0838 -020 -0 | | | | | 3,161
2015 Formulary |
|
-- |
|
|
2016 Harmony - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | 25% | 25% | 3,222 2016 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 |
2015 Health Net Seniority Plus Amber I (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0562 -055 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,810
2015 Formulary |
|
|
|
|
2016 Health Net Seniority Plus Amber I (HMO SNP)
| $31.00 |
n/a |
$270 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,057 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0562 -110 -1 | | | | | |
|
|
|
|
2016 Health Net Seniority Plus Amber II (HMO SNP)
| $31.00 |
n/a |
$280 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,057 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0562 -111 -1 | | | | | |
|
|
|
|
2016 Health Net Seniority Plus Sapphire (HMO)
| $31.00 |
$6,700 |
$290 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,057 2016 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 2015 --
|
H3561 -002 -0 | | | | | |
new |
new |
new |
|
2016 Health Net Seniority Plus Sapphire Premier (HMO)
| $31.00 |
$6,700 |
$310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,057 2016 Formulary |
|
2015 Healthy Heart Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0838 -031 -0 | $0.00 | 25% | 25% | 25% | 3,161
2015 Formulary |
|
-- |
|
|
2016 Healthy Heart - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,222 2016 Formulary |
|
2015 In Control Extra Care (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0838 -027 -0 | $0.00 | 25% | 25% | 25% | 3,161
2015 Formulary |
|
-- |
|
|
2016 In Control - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,222 2016 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 2015 --
|
H5649 -007 -0 | | | | | |
|
|
|
|
2016 Central Health Advance Plan (HMO SNP)
| $31.10 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 2,758 2016 Formulary |
|
2015 Central Health Medi-Medi Plan (HMO SNP)
| $28.80 |
n/a |
$320 | Yes, some additional gap coverage. |
H5649 -002 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,803
2015 Formulary |
|
|
|
|
2016 Central Health Medi-Medi Plan (HMO SNP)
| $31.10 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 2,758 2016 Formulary |
|
2015 Central Health Premier Plan (HMO)
| $28.80 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H5649 -004 -0 | $0.00 | $0.00 | 25% | 25% | 2,803
2015 Formulary |
|
|
|
|
2016 Central Health Premier Plan (HMO)
| $31.10 |
$6,700 |
$360 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 2,758 2016 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 |
2015 SCAN Connections (HMO SNP)
| $28.80 |
n/a |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5425 -010 -0 | | | | | 2,862
2015 Formulary |
|
|
|
|
2016 SCAN Connections (HMO SNP)
| $31.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,048 2016 Formulary |
|
2015 SCAN Connections at Home (HMO SNP)
| $28.80 |
n/a |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5425 -029 -0 | | | | | 2,862
2015 Formulary |
|
|
|
|
2016 SCAN Connections at Home (HMO SNP)
| $31.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,048 2016 Formulary |
|
2015 SCAN Plus (HMO)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5425 -045 -0 | | | | | 2,862
2015 Formulary |
|
|
|
|
2016 SCAN Plus (HMO)
| $31.10 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,048 2016 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 |
2015 VillageHealth (HMO SNP)
| $28.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5943 -002 -0 | | | | | 2,862
2015 Formulary |
|
|
|
|
2016 VillageHealth (HMO-POS SNP)
| $31.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,048 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5619 -022 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus H5619-022 (HMO)
| $39.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 3,607 2016 Formulary |
|
2015 Health Net Seniority Plus Amber II (HMO SNP)
| $28.80 |
$825 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0562 -070 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,810
2015 Formulary |
|
|
|
|
-- Members will be assigned to Health Net Seniority Plus Amber II (HMO SNP) H0562-110 --
| | | | | |
|
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 |
2015 Health Net Seniority Plus Sapphire (HMO)
| $28.80 |
$5,900 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0562 -104 -0 | $0.00 | $30.00 | $45.00 | $45.00 | 3,810
2015 Formulary |
|
|
|
|
-- Members will be assigned to Health Net Seniority Plus Sapphire (HMO) H0562-111 --
| | | | | |
|
2015 Humana Gold Plus H0108-011 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0108 -011 -0 | $0.00 | $10.00 | $30.00 | $30.00 | 3,617
2015 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H5619-021 (HMO) H5619-021 --
| | | | | |
|
2015 Humana Gold Plus H0108-047 (HMO)
| $28.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0108 -047 -0 | $0.00 | $2.00 | $30.00 | $30.00 | 3,617
2015 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H5619-022 (HMO) H5619-022 --
| | | | | |
|
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 |
2015 Humana Gold Plus H0108-050 (HMO)
| $22.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0108 -050 -0 | $0.00 | $2.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H5619-037 (HMO) H5619-037 --
| | | | | |
|
2015 Inter Valley Health Plan Service To Seniors (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0545 -001 -0 | $5.00 | $15.00 | $39.00 | $39.00 | 2,761
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Heart First (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5425 -028 -0 | $3.00 | $7.00 | $45.00 | $45.00 | 2,862
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
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 |
2015 Health Net Seniority Plus Complete (HMO)
| $176.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H0562 -106 -0 | $5.00 | $15.00 | $45.00 | $45.00 | 3,810
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Central Health Focus Plan (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5649 -005 -0 | $0.00 | $5.00 | $25.00 | $25.00 | 2,803
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|