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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SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Ashtabula | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Carroll | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Columbiana | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 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 | |||||||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Cuyahoga | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Erie | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Geauga | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 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 | |||||||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Huron | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Lake | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Lorain | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 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 | |||||||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Mahoning | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Medina | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Portage | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 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 | |||||||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Sandusky | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Stark | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Summit | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 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 | |||||||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Trumbull | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Tuscarawas | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) in OH - H3660-028-0 Benefit Details |
Wayne | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | n/a Browse Formulary | |||||
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