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 Option 2 (HMO) in IL - H2663-002-0 Benefit Details |
Calhoun | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in IL - H2663-002-0 Benefit Details |
Jersey | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in IL - H2663-002-0 Benefit Details |
Madison | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in IL - H2663-002-0 Benefit Details |
Monroe | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in IL - H2663-002-0 Benefit Details |
St. Clair | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Boone | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Callaway | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Cole | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Franklin | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Gasconade | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Jefferson | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Lincoln | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Miller | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Moniteau | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Montgomery | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Osage | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
St. Charles | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
St. Louis | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 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 Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
St. Louis City | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
Advantra Option 2 (HMO) in MO - H2663-002-0 Benefit Details |
Warren | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | n/a Browse Formulary | |||||
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