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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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Cass | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Ionia | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Kalamazoo | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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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 | |||||||||
PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Mason | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Missaukee | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Montcalm | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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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 | |||||||||
PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Muskegon | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Oceana | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Osceola | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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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 | |||||||||
PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Otsego | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
St. Clair | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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PriorityMedicare Select (PPO) in MI - H4875-012-0 Benefit Details |
Wexford | $78.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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