2010 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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65C Plus Basic Option BRx (Cost) in HI - H1251-003-0 Benefit Details |
Hawaii | $78.10 | $310 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Other Brand: $65.00 Injectables: 25% Specialty Drugs: 25% | n/a Browse Formulary | |||||
65C Plus Basic Option BRx (Cost) in HI - H1251-003-0 Benefit Details |
Honolulu | $78.10 | $310 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Other Brand: $65.00 Injectables: 25% Specialty Drugs: 25% | n/a Browse Formulary | |||||
65C Plus Basic Option BRx (Cost) in HI - H1251-003-0 Benefit Details |
Kalawao | $78.10 | $310 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Other Brand: $65.00 Injectables: 25% Specialty Drugs: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
65C Plus Basic Option BRx (Cost) in HI - H1251-003-0 Benefit Details |
Kauai | $78.10 | $310 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Other Brand: $65.00 Injectables: 25% Specialty Drugs: 25% | n/a Browse Formulary | |||||
65C Plus Basic Option BRx (Cost) in HI - H1251-003-0 Benefit Details |
Maui | $78.10 | $310 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Other Brand: $65.00 Injectables: 25% Specialty Drugs: 25% | n/a Browse Formulary | |||||
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