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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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Abbeville | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Aiken | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Allendale | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | 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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Anderson | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Bamberg | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Barnwell | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Beaufort | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Berkeley | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Calhoun | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Charleston | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Cherokee | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Chester | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Chesterfield | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Clarendon | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Colleton | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | 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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Darlington | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
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Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Dillon | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Dorchester | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Edgefield | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Fairfield | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Florence | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Georgetown | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Greenville | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Greenwood | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Hampton | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Horry | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Jasper | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Kershaw | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Lancaster | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Laurens | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Lee | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Lexington | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Marion | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Marlboro | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
McCormick | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Newberry | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
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 | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Oconee | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Orangeburg | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Pickens | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Richland | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Saluda | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Spartanburg | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Sumter | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Union | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
Williamsburg | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Guardian Tribute (PFFS) in SC - H4917-001-0 Benefit Details |
York | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new |
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