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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Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Baldwin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Banks | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Barrow | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Bartow | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Ben Hill | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Berrien | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Bibb | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Bulloch | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Burke | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Butts | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Calhoun | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Carroll | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Charlton | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Chattooga | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Clay | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Clinch | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Colquitt | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Crawford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Crisp | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Dawson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Decatur | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Dooly | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Dougherty | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Echols | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Elbert | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Evans | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Fannin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Floyd | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Franklin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Gilmer | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Glascock | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Gordon | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Grady | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Habersham | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Hall | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Hancock | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Haralson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Hart | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Heard | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Houston | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Irwin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Jackson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Jasper | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Jefferson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Jenkins | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Johnson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Jones | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lamar | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lanier | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lee | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lincoln | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Long | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lowndes | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Lumpkin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Macon | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
McDuffie | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Meriwether | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Miller | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Mitchell | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Monroe | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Murray | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Peach | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Pickens | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Pike | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Polk | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Pulaski | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Rabun | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Randolph | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Schley | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Spalding | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Stephens | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Sumter | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Taliaferro | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Taylor | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Telfair | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Terrell | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Tift | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Towns | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Treutlen | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Troup | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Turner | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Union | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Upson | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Walton | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Warren | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Washington | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
White | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Whitfield | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Wilcox | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Wilkes | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Presidential Plus (PFFS) in GA - H9720-039-0 Benefit Details |
Worth | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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