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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HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Columbia | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Crawford | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Dane | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 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 | |||||||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Green | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Iowa | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Jefferson | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 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 | |||||||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Lafayette | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Richland | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Rock | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 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 | |||||||||
HumanaChoice H5216-006 (PPO) in WI - H5216-006-0 Benefit Details |
Sauk | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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