2014 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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Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Alexandria City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Arlington | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Fairfax | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
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 | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Fairfax City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Falls Church City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Loudoun | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
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 | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Manassas City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Manassas Park City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in VA - H2150-002-0 Benefit Details |
Prince William | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
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 | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in DC - H2150-002-0 Benefit Details |
District of Columbia | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Anne Arundel | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Baltimore | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Baltimore City | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Calvert | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Carroll | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Charles | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Frederick | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Harford | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Howard | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Montgomery | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||||
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost) in MD - H2150-002-0 Benefit Details |
Prince George's | $113.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
-- | Higher cost-sharing at standard network pharmacies. Details: |
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