2010 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Belmont | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Columbiana | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Delaware | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 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 | |||||||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Fairfield | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Franklin | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Harrison | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 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 | |||||||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Jefferson | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Licking | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Madison | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 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 | |||||||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Mahoning | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Muskingum | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Trumbull | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 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 | |||||||||
Anthem Senior Advantage Value (HMO) in OH - H3655-031-0 Benefit Details |
Union | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $0.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | n/a Browse Formulary | |||||
|