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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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Adjuntas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Aguada | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Aguadilla | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Aguas Buenas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Aibonito | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Anasco | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Arecibo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Arroyo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Barceloneta | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Barranquitas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Bayamon | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Cabo Rojo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Caguas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Camuy | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Canovanas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Carolina | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Catano | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Cayey | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Ceiba | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Ciales | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Cidra | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Coamo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Comerio | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Corozal | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Culebra | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Dorado | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Fajardo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Florida | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Guanica | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Guayama | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Guayanilla | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Guaynabo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Gurabo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Hatillo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Hormigueros | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Humacao | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Isabela | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Jayuya | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Juana Diaz | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Juncos | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Lajas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Lares | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Las Marias | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Las Piedras | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Loiza | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Luquillo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Manati | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Maricao | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Maunabo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Mayaguez | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Moca | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Morovis | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Naguabo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Naranjito | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Orocovis | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Patillas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Penuelas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Ponce | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Quebradillas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Rincon | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Rio Grande | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Sabana Grande | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Salinas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
San German | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
San Juan | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
San Lorenzo | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
San Sebastian | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Santa Isabel | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Toa Alta | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Toa Baja | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Trujillo Alto | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Utuado | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Vega Alta | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Vega Baja | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Vieques | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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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 | |||||||||
Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Villalba | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Yabucoa | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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Humana Gold Plus SNP-DE H4007-005 (HMO SNP) in PR - H4007-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Yauco | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% | n/a Browse Formulary | |||||
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