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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BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Bedford | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Cheatham | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Coffee | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 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 | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Davidson | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Dickson | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Giles | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 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 | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Hickman | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Houston | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Humphreys | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 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 | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Lawrence | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Lewis | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Lincoln | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Marshall | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Maury | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Montgomery | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Moore | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Perry | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Robertson | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Rutherford | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Stewart | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Sumner | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Trousdale | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Wayne | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Williamson | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Diamond (PPO) in TN - H7917-009-0 Benefit Details |
Wilson | $154.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $30.00 Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
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