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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Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Gibson | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Knox | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Perry | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 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 | |||||||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Pike | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Posey | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Spencer | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 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 | |||||||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Vanderburgh | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
Platinum Select Rx (HMO-POS) in IN - H3044-004-0 Benefit Details |
Warrick | $201.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $3,200 Browse Formulary | |||||
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