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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IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Benton | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Blackford | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Boone | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Brown | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Carroll | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Clay | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Clinton | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Delaware | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Grant | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Greene | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Hamilton | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Hancock | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Hendricks | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Henry | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Howard | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Jay | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Johnson | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Lawrence | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Marion | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Monroe | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Morgan | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Orange | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Owen | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Parke | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Putnam | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Randolph | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Shelby | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Tippecanoe | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Tipton | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Vermillion | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 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 | |||||||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
Vigo | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
IU Health Plans Medicare Choice (HMO-POS) in IN - H7220-004-0 Benefit Details |
White | $98.00 | $0 | Many Generics | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
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