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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Anthem MediBlue Select (HMO) in NH - H3536-001-0 Benefit Details |
Hillsborough | $30.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Injectable Drugs: $95.00 Tier 6: 33% | $5,000 Browse Formulary | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem MediBlue Select (HMO) in NH - H3536-001-0 Benefit Details |
Rockingham | $30.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Injectable Drugs: $95.00 Tier 6: 33% | $5,000 Browse Formulary | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: |
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