2012 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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AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Baxter | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Benton | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Boone | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Carroll | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Conway | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Crawford | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Franklin | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Fulton | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Johnson | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Lee | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Lincoln | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Logan | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Madison | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Marion | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Newton | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Ouachita | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Perry | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Phillips | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Pope | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Randolph | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Scott | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Searcy | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Sebastian | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
St. Francis | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Stone | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Van Buren | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) in AR - H4213-007-0 Benefit Details |
Washington | $37.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $4,750 Browse Formulary | |||||
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