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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SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Anderson | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Austin | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Bastrop | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Bell | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Bosque | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Brazos | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Burleson | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Burnet | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Cass | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Cherokee | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Coke | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Coleman | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Concho | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Coryell | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Crockett | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Falls | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Fayette | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Freestone | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Gregg | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Grimes | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Hamilton | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Harrison | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Henderson | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Hill | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Irion | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Kimble | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Lampasas | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Lee | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Leon | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Limestone | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Llano | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Madison | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Marion | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Mason | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
McCulloch | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
McLennan | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Menard | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Milam | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Mills | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Rains | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Reagan | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Robertson | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Runnels | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Rusk | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
San Saba | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Schleicher | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Smith | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Somervell | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Sterling | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Sutton | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Tom Green | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Travis | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Van Zandt | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Waller | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Washington | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Williamson | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
SeniorCare Sr MedOption - Value Rx (Cost) in TX - H4564-023-0 Benefit Details |
Wood | $213.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
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