2011 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) Additional 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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Gold Advantage Option 1 (HMO) in IL - H2663-005-0 Benefit Details |
Calhoun | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in IL - H2663-005-0 Benefit Details |
Jersey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in IL - H2663-005-0 Benefit Details |
Madison | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in IL - H2663-005-0 Benefit Details |
Monroe | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in IL - H2663-005-0 Benefit Details |
St. Clair | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Callaway | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Cole | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Franklin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Gasconade | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Jefferson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Lincoln | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Miller | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Moniteau | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Montgomery | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Osage | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
St. Charles | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
St. Louis | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
St. Louis City | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) in MO - H2663-005-0 Benefit Details |
Warren | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
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