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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AlohaCare Advantage (HMO) in HI - H5969-001-0 Benefit Details |
Hawaii | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $80.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
AlohaCare Advantage (HMO) in HI - H5969-001-0 Benefit Details |
Honolulu | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $80.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
AlohaCare Advantage (HMO) in HI - H5969-001-0 Benefit Details |
Kalawao | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $80.00 Tier 5: 33% | $3,400 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 | |||||||||
AlohaCare Advantage (HMO) in HI - H5969-001-0 Benefit Details |
Kauai | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $80.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
AlohaCare Advantage (HMO) in HI - H5969-001-0 Benefit Details |
Maui | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $80.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
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