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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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Adams | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Allegheny | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Armstrong | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Beaver | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Bedford | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Berks | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Blair | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Bradford | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Butler | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Cambria | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Cameron | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Carbon | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Centre | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Clarion | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Clearfield | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Clinton | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Columbia | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Crawford | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Cumberland | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Dauphin | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Elk | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Erie | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Fayette | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Forest | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Franklin | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Fulton | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Greene | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Huntingdon | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Indiana | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Jefferson | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Juniata | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lackawanna | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lancaster | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lawrence | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lebanon | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lehigh | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Luzerne | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Lycoming | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
McKean | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Mercer | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Mifflin | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Monroe | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Montour | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Northampton | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Northumberland | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Perry | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Pike | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Potter | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Schuylkill | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Snyder | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Somerset | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Sullivan | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Susquehanna | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Tioga | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Union | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Venango | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Warren | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Washington | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Wayne | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Westmoreland | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 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 | |||||||||
FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
Wyoming | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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FreedomBlue PFFS Choice Plus (PFFS) in PA - H9793-001-0 Benefit Details |
York | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $90.00 Specialty: 33% | n/a Browse Formulary | |||||
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