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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MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Adjuntas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Aguada | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Aguadilla | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Aguas Buenas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Aibonito | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Anasco | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Arecibo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Arroyo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Barceloneta | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Barranquitas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Bayamon | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Cabo Rojo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Caguas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Camuy | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Canovanas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Carolina | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Catano | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Cayey | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Ceiba | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Ciales | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Cidra | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Coamo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Comerio | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Corozal | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Culebra | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Dorado | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Fajardo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Florida | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Guanica | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Guayama | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Guayanilla | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Guaynabo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Gurabo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Hatillo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Hormigueros | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Humacao | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Isabela | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Jayuya | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Juana Diaz | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Juncos | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Lajas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Lares | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Las Marias | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Las Piedras | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Loiza | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Luquillo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Manati | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Maricao | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Maunabo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Mayaguez | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Moca | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Morovis | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Naguabo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Naranjito | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Orocovis | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Patillas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Penuelas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Ponce | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Quebradillas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Rincon | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Rio Grande | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Sabana Grande | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Salinas | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
San German | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
San Juan | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
San Lorenzo | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
San Sebastian | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Santa Isabel | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Toa Alta | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Toa Baja | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Trujillo Alto | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Utuado | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Vega Alta | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Vega Baja | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Vieques | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 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 | |||||||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Villalba | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Yabucoa | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
MCS Classicare FlexiCare (HMO-POS) in PR - H5577-012-0 Benefit Details |
Yauco | $43.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $14.00 Non-Preferred Brand: $28.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
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