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 - H7917-010-0 Benefit Details |
Anderson | $151.00 | $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 - H7917-010-0 Benefit Details |
Bledsoe | $151.00 | $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 - H7917-010-0 Benefit Details |
Blount | $151.00 | $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 - H7917-010-0 Benefit Details |
Bradley | $151.00 | $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 - H7917-010-0 Benefit Details |
Campbell | $151.00 | $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 - H7917-010-0 Benefit Details |
Cannon | $151.00 | $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 - H7917-010-0 Benefit Details |
Claiborne | $151.00 | $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 - H7917-010-0 Benefit Details |
Clay | $151.00 | $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 - H7917-010-0 Benefit Details |
Cocke | $151.00 | $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 - H7917-010-0 Benefit Details |
Cumberland | $151.00 | $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 - H7917-010-0 Benefit Details |
DeKalb | $151.00 | $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 - H7917-010-0 Benefit Details |
Fentress | $151.00 | $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 - H7917-010-0 Benefit Details |
Franklin | $151.00 | $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 - H7917-010-0 Benefit Details |
Grainger | $151.00 | $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 - H7917-010-0 Benefit Details |
Grundy | $151.00 | $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 - H7917-010-0 Benefit Details |
Hamblen | $151.00 | $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 - H7917-010-0 Benefit Details |
Hamilton | $151.00 | $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 - H7917-010-0 Benefit Details |
Jackson | $151.00 | $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 - H7917-010-0 Benefit Details |
Jefferson | $151.00 | $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 - H7917-010-0 Benefit Details |
Knox | $151.00 | $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 - H7917-010-0 Benefit Details |
Loudon | $151.00 | $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 - H7917-010-0 Benefit Details |
Macon | $151.00 | $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 - H7917-010-0 Benefit Details |
Marion | $151.00 | $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 - H7917-010-0 Benefit Details |
McMinn | $151.00 | $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 - H7917-010-0 Benefit Details |
Meigs | $151.00 | $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 - H7917-010-0 Benefit Details |
Monroe | $151.00 | $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 - H7917-010-0 Benefit Details |
Morgan | $151.00 | $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 - H7917-010-0 Benefit Details |
Overton | $151.00 | $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 - H7917-010-0 Benefit Details |
Pickett | $151.00 | $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 - H7917-010-0 Benefit Details |
Polk | $151.00 | $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 - H7917-010-0 Benefit Details |
Putnam | $151.00 | $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 - H7917-010-0 Benefit Details |
Rhea | $151.00 | $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 - H7917-010-0 Benefit Details |
Roane | $151.00 | $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 - H7917-010-0 Benefit Details |
Scott | $151.00 | $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 - H7917-010-0 Benefit Details |
Sequatchie | $151.00 | $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 - H7917-010-0 Benefit Details |
Sevier | $151.00 | $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 - H7917-010-0 Benefit Details |
Smith | $151.00 | $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 - H7917-010-0 Benefit Details |
Union | $151.00 | $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 - H7917-010-0 Benefit Details |
Van Buren | $151.00 | $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 - H7917-010-0 Benefit Details |
Warren | $151.00 | $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 - H7917-010-0 Benefit Details |
White | $151.00 | $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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