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 Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Androscoggin | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Cumberland | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Franklin | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 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 | |||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Hancock | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Kennebec | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Lincoln | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 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 | |||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Oxford | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Penobscot | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Piscataquis | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 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 | |||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Sagadahoc | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Somerset | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Waldo | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 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 | |||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
Washington | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Anthem Medicare Preferred Premier (PPO) in ME - H6786-001-0 Benefit Details |
York | $96.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $18.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: $95.00 Select Care Drugs: 33% | $6,000 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: |
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