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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AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Arkansas | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Calhoun | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Chicot | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Clark | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Clay | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Cleburne | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Columbia | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Cross | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Desha | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Drew | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Garland | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Hempstead | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Hot Spring | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Independence | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Jackson | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Lafayette | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Lawrence | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Little River | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Mississippi | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Prairie | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
Saline | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) in AR - H4213-006-0 Benefit Details |
White | $84.40 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 25% | n/a Browse Formulary | |||||
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