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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AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Bienville | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Bossier | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Caddo | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Caldwell | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Cameron | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Catahoula | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Claiborne | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Concordia | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
De Soto | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
East Carroll | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Franklin | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Grant | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Jackson | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
La Salle | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Lincoln | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Madison | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Morehouse | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Natchitoches | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Ouachita | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Rapides | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Red River | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Richland | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Sabine | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Tensas | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Union | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Webster | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
West Carroll | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 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 | |||||||||
AAA3 Vantage PREMIUM (HMO-POS) in LA - H5576-006-0 Benefit Details |
Winn | $132.00 | $325 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 25% | $5,200 Browse Formulary | |||||
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