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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Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Alamance | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Alexander | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Caldwell | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 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 | |||||||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Caswell | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Catawba | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Chatham | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 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 | |||||||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Durham | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Franklin | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Gaston | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 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 | |||||||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Guilford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Person | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Randolph | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Rockingham | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Advantra Bronze (PPO) in NC - H9847-004-0 Benefit Details |
Wake | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
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