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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Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Bourbon | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Douglas | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Johnson | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 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 | |||||||||
Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Leavenworth | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Linn | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in KS - H5509-013-0 Benefit Details |
Miami | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 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 | |||||||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Benton | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Carroll | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Cass | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 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 | |||||||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Clay | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Clinton | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Henry | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 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 | |||||||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Jackson | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Johnson | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Lafayette | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 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 | |||||||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Livingston | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Platte | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
Advantra Freedom (PPO) in MO - H5509-013-0 Benefit Details |
Saline | $29.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | n/a Browse Formulary | |||||
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