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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HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Ashland | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Barron | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Bayfield | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Buffalo | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Burnett | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Dunn | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Eau Claire | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Iron | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Jackson | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
La Crosse | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Lincoln | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Monroe | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Oneida | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Pepin | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Polk | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Price | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Sawyer | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
St. Croix | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Taylor | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Trempealeau | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Vilas | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 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 | |||||||||
HumanaChoice H5216-007 (PPO) in WI - H5216-007-0 Benefit Details |
Washburn | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
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