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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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Alachua | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Baker | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Bay | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Bradford | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Brevard | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Broward | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Calhoun | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Charlotte | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Citrus | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Clay | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Collier | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Columbia | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Dade | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
DeSoto | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Dixie | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Duval | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Escambia | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Flagler | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Franklin | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Gadsden | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Gilchrist | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Glades | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Gulf | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Hamilton | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Hardee | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Hendry | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Hernando | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Highlands | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Hillsborough | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Holmes | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Indian River | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Jackson | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Jefferson | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Lafayette | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Lake | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Lee | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Leon | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Levy | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Liberty | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Madison | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Manatee | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Marion | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Martin | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Monroe | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Nassau | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Okaloosa | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Okeechobee | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Orange | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Osceola | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Palm Beach | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Pasco | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Pinellas | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Polk | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Putnam | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Santa Rosa | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Sarasota | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Seminole | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
St. Johns | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
St. Lucie | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Sumter | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Suwannee | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Taylor | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Union | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Volusia | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Wakulla | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Walton | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
BlueMedicare PFFS (PFFS) in FL - H3518-001-0 Benefit Details |
Washington | $151.00 | $145 | No Gap Coverage | Tier 1 - Covered Generic: $4.00 Tier 2 - Covered Preferred Brand: $45.00 Tier 3 - Covered Brand: $95.00 Tier S - Covered Specialty: 25% | n/a Browse Formulary | |||||
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