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2010 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) Gap Coverage | Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Members In This Plan ID | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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Clarian Medicare Value (HMO) - H7220-001-0 Benefit Details |
Hendricks | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 144 members | ||||||
new | new | new | |||||||||
HumanaChoice R5826-066 (Regional PPO) - R5826-066-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,845 members | ||||||
HumanaChoice R5826-066 (Regional PPO) - R5826-066-0 Benefit Details |
Hendricks | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,845 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Hendricks | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Blue Medicare Access Value (Regional PPO) - R5941-009-0 Benefit Details |
Statewide | $14.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 20,413 members Browse Formulary | |||||
Blue Medicare Access Value (Regional PPO) - R5941-009-0 Benefit Details |
Hendricks | $14.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 20,413 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Anthem Medicare Preferred Standard (PPO) - H1607-001-0 Benefit Details |
Hendricks | $18.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 3,322 members Browse Formulary | |||||
Humana Gold Plus H2012-009 (HMO) - H2012-009-0 Benefit Details |
Hendricks | $20.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 699 members Browse Formulary | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Hendricks | $23.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $8.00 Tier 2 Preferred Brand Certain Generic Drugs: $44.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 15,526 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
ADVANTAGE Preferred Plus (PPO) - H5508-002-0 Benefit Details |
Hendricks | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 378 members | ||||||
Today's Options Value (PFFS) - H5421-055-0 Benefit Details |
Hendricks | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,383 members | ||||||
Evercare Plan DP (PPO) - H1509-004-0 Benefit Details |
Hendricks | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare Access Standard (Regional PPO) - R5941-003-0 Benefit Details |
Statewide | $32.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 14,451 members Browse Formulary | |||||
Blue Medicare Access Standard (Regional PPO) - R5941-003-0 Benefit Details |
Hendricks | $32.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 14,451 members Browse Formulary | |||||
AARP MedicareComplete Choice (PPO) - H1509-007-0 Benefit Details |
Hendricks | $35.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 5,102 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Evercare Plan IP (PPO) - H1509-006-0 Benefit Details |
Hendricks | $35.80 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | < 10 members Browse Formulary | |||||
Clarian Medicare Select (HMO) - H7220-002-0 Benefit Details |
Hendricks | $37.20 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 211 members | ||||||
new | new | new | |||||||||
CIGNA Medicare Access Plan One (PFFS) - H2762-013-0 Benefit Details |
Hendricks | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 337 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-073-0 Benefit Details |
Hendricks | $51.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 10,805 members Browse Formulary | |||||
Anthem Medicare Preferred Select (PPO) - H1607-004-0 Benefit Details |
Hendricks | $55.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 368 members Browse Formulary | |||||
HumanaChoice H1510-001 (PPO) - H1510-001-0 Benefit Details |
Hendricks | $56.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,652 members Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
ADVANTAGE Preferred Plus Part D Basic (PPO) - H5508-003-0 Benefit Details |
Hendricks | $59.00 | $0 | No Gap Coverage | Preferred Generic: $8.00 Generic: $8.00 Preferred Brand: $45.00 Specialty: 33% Non-Preferred Agents: $80.00 | 645 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-030-0 Benefit Details |
Hendricks | $60.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | n/a Browse Formulary | |||||
HumanaChoice R5826-082 (Regional PPO) - R5826-082-0 Benefit Details |
Statewide | $63.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 630 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-082 (Regional PPO) - R5826-082-0 Benefit Details |
Hendricks | $63.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 630 members Browse Formulary | |||||
Clarian Medicare Select Plus (HMO) - H7220-003-0 Benefit Details |
Hendricks | $66.90 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 30% | n/a Browse Formulary | |||||
new | new | new | |||||||||
ADVANTAGE Preferred Plus Part D Enhanced (PPO) - H5508-001-0 Benefit Details |
Hendricks | $69.00 | $0 | Many Generics | Preferred Generic: $8.00 Generic: $8.00 Preferred Brand: $45.00 Specialty: 33% Non-Preferred Agents: $80.00 | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier (PFFS) - H5421-049-0 Benefit Details |
Hendricks | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,597 members | ||||||
HumanaChoice R5826-008 (Regional PPO) - R5826-008-0 Benefit Details |
Statewide | $73.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 11,392 members Browse Formulary | |||||
HumanaChoice R5826-008 (Regional PPO) - R5826-008-0 Benefit Details |
Hendricks | $73.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 11,392 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Clarian Medicare Choice (HMO-POS) - H7220-004-0 Benefit Details |
Hendricks | $92.90 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 30% | 5,445 members Browse Formulary | |||||
new | new | new | |||||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-017-0 Benefit Details |
Hendricks | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 165 members | ||||||
Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details |
Hendricks | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-067-0 Benefit Details |
Hendricks | $112.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,339 members Browse Formulary | |||||
ADVANTAGE Enhanced Plus (PPO) - H5508-004-0 Benefit Details |
Hendricks | $125.00 | $0 | Many Generics | Preferred Generic: $8.00 Generic: $8.00 Preferred Brand: $45.00 Specialty: 33% Non-Preferred Agents: $80.00 | 687 members Browse Formulary | |||||
Humana Gold Choice H2944-125 (PFFS) - H2944-125-0 Benefit Details |
Hendricks | $131.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-038-0 Benefit Details |
Hendricks | $135.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 442 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
Hendricks | $170.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-3 Benefit Details |
Hendricks | $183.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option IV (PFFS) - H5006-016-3 Benefit Details |
Hendricks | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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