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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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Belmont | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Guernsey | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Harrison | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Jefferson | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Monroe | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Muskingum | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Noble | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in OH - H8604-003-0 Benefit Details |
Washington | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Barbour | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Brooke | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Calhoun | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Doddridge | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Gilmer | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Hancock | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Harrison | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Lewis | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Marion | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Marshall | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Monongalia | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Ohio | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Pleasants | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Preston | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Randolph | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Ritchie | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Taylor | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Tucker | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Tyler | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Upshur | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Webster | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Wetzel | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% 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 | |||||||||
SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Wirt | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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SecureChoice - Option II (PPO) in WV - H8604-003-0 Benefit Details |
Wood | $111.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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