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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Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Black Hawk | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Bremer | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Buchanan | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | 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 | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Butler | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Carroll | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Cedar | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | 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 | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Dallas | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Decatur | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Delaware | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | 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 | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Fayette | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Grundy | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Jasper | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Johnson | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Jones | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Linn | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Lucas | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Madison | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Marion | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Monroe | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Muscatine | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Plymouth | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Polk | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Poweshiek | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Scott | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Warren | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Washington | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Winneshiek | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Woodbury | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
Advantra Silver (HMO) in IA - H1609-001-0 Benefit Details |
Wright | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | n/a Browse Formulary | |||||
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