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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Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Anderson | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Camp | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Cherokee | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Franklin | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Freestone | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Hopkins | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Houston | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Kaufman | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Marion | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Morris | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Navarro | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Panola | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Rusk | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Shelby | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Smith | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Trinity | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Upshur | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Van Zandt | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 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 | |||||||||
Texas Community Care - Plus (HMO) in TX - H4529-014-0 Benefit Details |
Wood | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
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