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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Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Grays Harbor | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Island | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
King | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 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 | |||||||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Kitsap | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Lewis | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Mason | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 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 | |||||||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Pierce | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
San Juan | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Skagit | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 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 | |||||||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Snohomish | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Spokane | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Thurston | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 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 | |||||||||
Group Health Cooperative Clear Care Vital (HMO) in WA - H5050-013-0 Benefit Details |
Whatcom | $19.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $11.00 Tier 4: 50% | $3,200 Browse Formulary | |||||
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