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2010 Medicare Prescription Drug Plan Benefit Details for the Health Net Orange Option 1 (PDP)
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2010 Medicare Prescription Drug Plan Details
Medicare Plan Name:Health Net Orange Option 1 (PDP)
   by Health Net
State:Nebraska
Plan ID:S5678 - 056 - 0     Click to see other plans
Member Services:1-800-806-8811 TTY users 1-800-929-9955
— 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
Email a copy of the Health Net Orange Option 1 (PDP) benefit details
— Medicare Plan Features —
Monthly Premium:$37.90
Annual Deductible:$310
$0 Premium if LIS Benefits?No, this plan does NOT qualify for the $0 Premium.
Annual Initial Coverage Limit (ICL):$2,830
Drug Benefit Type ❔Actuarially Equivalent Standard (AE)
Gap Coverage?No Gap Coverage
Total Number of Formulary Drugs:3,650 drugsBrowse the Health Net Orange Option 1 (PDP) Formulary
This plan has 5 drug tiers. See cost-sharing highlights below.
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$4.00$40.00$95.0025%25%
• Number of Drugs per
  Tier:		1423600681686260
Plan Offers Mail Order?Yes
Plan Type (Reach):National Plan
Number of Members enrolled in this plan in your CMS Region:920 members     (CMS Region 25)
Number of Members enrolled in this plan nationally:381,952 members




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