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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Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Aitkin | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Anoka | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Becker | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Beltrami | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Benton | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Big Stone | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Blue Earth | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Brown | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Carlton | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Carver | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Cass | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Chippewa | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Chisago | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Clay | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Clearwater | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Cottonwood | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Crow Wing | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Dakota | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Dodge | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Douglas | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Faribault | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Fillmore | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Freeborn | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Goodhue | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Grant | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Hennepin | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Hubbard | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Isanti | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Itasca | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Jackson | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Kanabec | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Kandiyohi | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Kittson | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Koochiching | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Lac qui Parle | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Lake | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Le Sueur | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Lincoln | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Lyon | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Mahnomen | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Marshall | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Martin | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
McLeod | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Meeker | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Mille Lacs | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Morrison | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Mower | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Murray | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Nicollet | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Nobles | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Norman | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Olmsted | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Otter Tail | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Pine | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Pipestone | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Polk | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Pope | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Ramsey | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Red Lake | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Redwood | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Renville | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Rice | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Rock | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Roseau | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Scott | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Sherburne | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Sibley | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
St. Louis | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Stearns | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Steele | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Stevens | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Swift | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Todd | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Traverse | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Wabasha | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Wadena | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Waseca | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Washington | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Watonwan | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Wilkin | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Wright | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in MN - H2410-009-0 Benefit Details |
Yellow Medicine | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Barnes | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Cass | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Dickey | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
LaMoure | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Ransom | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Richland | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Sargent | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Stutsman | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 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 | |||||||||
Medica Advantage Solution Choice (PFFS) in ND - H2410-009-0 Benefit Details |
Traill | $29.10 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
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