2013 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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Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Adams | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Berks | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Bradford | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Carbon | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Centre | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Clinton | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Columbia | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Cumberland | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Dauphin | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Franklin | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Fulton | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Juniata | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Lackawanna | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Lancaster | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Lebanon | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Lehigh | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Luzerne | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Lycoming | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Mifflin | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Monroe | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Montour | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Northampton | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Northumberland | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Perry | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Pike | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Schuylkill | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Snyder | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Sullivan | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Susquehanna | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Tioga | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Union | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Wayne | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
Wyoming | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Freedom Blue PPO Value (PPO) in PA - H3916-012-0 Benefit Details |
York | $81.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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