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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BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Alachua | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Baker | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Bay | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $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 | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Bradford | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Brevard | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Broward | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Calhoun | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Charlotte | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Citrus | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Clay | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Collier | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Columbia | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $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 | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
DeSoto | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Dixie | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Duval | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Escambia | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Flagler | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Franklin | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Gadsden | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Gilchrist | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Glades | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Gulf | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Hamilton | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Hardee | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Hendry | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Hernando | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Highlands | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Hillsborough | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Holmes | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Indian River | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Jackson | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Jefferson | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Lafayette | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Lake | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Lee | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Leon | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Levy | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Liberty | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Madison | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Manatee | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Marion | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Martin | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Miami-Dade | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Monroe | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Nassau | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Okaloosa | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Okeechobee | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Orange | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Osceola | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Palm Beach | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Pasco | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Pinellas | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Polk | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Putnam | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Santa Rosa | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Sarasota | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Seminole | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
St. Johns | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
St. Lucie | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Sumter | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $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 | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Suwannee | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Taylor | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Union | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $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 | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Volusia | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Wakulla | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Walton | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $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 | |||||||||
BlueMedicare Regional PPO (Regional PPO) in FL - R3332-001-0 Benefit Details |
Washington | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
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