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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Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Anne Arundel | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Baltimore | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Baltimore City | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | 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 | |||||||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Calvert | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Carroll | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Cecil | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | 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 | |||||||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Charles | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Frederick | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Harford | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | 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 | |||||||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Howard | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Montgomery | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) in MD - H5521-036-0 Benefit Details |
Prince George's | $140.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $28.00 Tier 4 - Non-Preferred Brand: $68.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
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