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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AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
East Baton Rouge | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
East Feliciana | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
Iberville | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 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 | |||||||||
AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
Pointe Coupee | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
West Baton Rouge | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
AAA6 Vantage CAPITOL (HMO-POS) in LA - H5576-012-0 Benefit Details |
West Feliciana | $0.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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