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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Ambassador Plus (PPO) in NC - H6881-002-0 Benefit Details |
Durham | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Ambassador Plus (PPO) in NC - H6881-002-0 Benefit Details |
Iredell | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Ambassador Plus (PPO) in NC - H6881-002-0 Benefit Details |
Mecklenburg | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 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 | |||||||||
Ambassador Plus (PPO) in NC - H6881-002-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Ambassador Plus (PPO) in NC - H6881-002-0 Benefit Details |
Wake | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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