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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Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Aiken | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Calhoun | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Chester | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $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 | |||||||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Clarendon | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Edgefield | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Fairfield | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $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 | |||||||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Greenwood | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Lexington | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
McCormick | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $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 | |||||||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Newberry | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Orangeburg | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Richland | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $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 | |||||||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Saluda | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
Medicare Blue (PPO) in SC - H4209-009-0 Benefit Details |
Sumter | $38.50 | $195 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
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