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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UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Ashland | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Barron | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Bayfield | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Buffalo | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Burnett | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Chippewa | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Crawford | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Douglas | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Dunn | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Eau Claire | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Grant | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Iowa | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Jackson | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Juneau | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
La Crosse | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Monroe | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Pepin | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Pierce | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Polk | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Richland | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Sauk | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Sawyer | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
St. Croix | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Trempealeau | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Vernon | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) in WI - H4270-002-0 Benefit Details |
Washburn | $147.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
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