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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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BlueCross BlueShield Senior Blue HMO 601 (HMO) - H3384-022-0 Benefit Details |
Wyoming | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,508 members | ||||||
BlueCross BlueShield Senior Blue HMO 651 PartD (HMO) - H3384-019-0 Benefit Details |
Wyoming | $0.00 | $0 | Few Generics | Formulary Generic: $5.00 Preferred Brand: $35.00 Non-Preferred: 50% Specialty Injectables: 30% | 5,524 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-020-0 Benefit Details |
Wyoming | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 13,290 members | ||||||
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 Two (PFFS) - H2762-042-0 Benefit Details |
Wyoming | $0.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 40,257 members Browse Formulary | |||||
Independent Health Encompass 65 Basic (HMO) - H3362-017-0 Benefit Details |
Wyoming | $0.00 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $45.00 Tier 3: $85.00 Specialty Tier 4: 33% | 5,062 members Browse Formulary | |||||
SecureHorizons MedicareComplete Choice (Regional PPO) - R5342-001-0 Benefit Details |
Wyoming | $0.00 | $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% | 13,222 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareComplete Choice (Regional PPO) - R5342-001-0 Benefit Details |
Statewide | $0.00 | $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% | 13,222 members Browse Formulary | |||||
SecureHorizons MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Benefit Details |
Wyoming | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 748 members | ||||||
SecureHorizons MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 748 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 (PFFS) - H3333-038-0 Benefit Details |
Wyoming | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Independent Health Encompass 65 (HMO) - H3362-016-0 Benefit Details |
Wyoming | $6.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,770 members | ||||||
SeniorChoice Value (HMO) - H3351-010-0 Benefit Details |
Wyoming | $16.00 | $150 | No Gap Coverage | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) - H3333-056-0 Benefit Details |
Wyoming | $19.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
BlueCross BlueShield Senior Blue HMO 602 (HMO) - H3384-051-0 Benefit Details |
Wyoming | $21.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Evercare Plan RDP (Regional PPO) - R5342-003-0 Benefit Details |
Wyoming | $ 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% | 4,933 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 RDP (Regional PPO) - R5342-003-0 Benefit Details |
Statewide | $ 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% | 4,933 members Browse Formulary | |||||
Evercare Plan RMP (Regional PPO) - R5342-004-0 Benefit Details |
Wyoming | $25.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | n/a Browse Formulary | |||||
Evercare Plan RMP (Regional PPO) - R5342-004-0 Benefit Details |
Statewide | $25.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 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 | |||||||||
Today's Options Premier (PFFS) - H3333-032-0 Benefit Details |
Wyoming | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 7,958 members | ||||||
BlueCross BlueShield Senior Blue HMO 652 PartD (HMO) - H3384-052-0 Benefit Details |
Wyoming | $33.00 | $0 | Few Generics | Formulary Generic: $5.00 Preferred Brand: $35.00 Non-Preferred: 50% Specialty Injectables: 30% | 6,013 members Browse Formulary | |||||
Evercare Plan IH (HMO) - H3379-022-0 Benefit Details |
Wyoming | $33.30 | $310 | 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 | |||||||||
Independent Health Encompass 65 (HMO) - H3362-003-0 Benefit Details |
Wyoming | $33.30 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $45.00 Tier 3: $75.00 Specialty Tier 4: 33% | 24,697 members Browse Formulary | |||||
Independent Health Medicare Anywhere Basic (PFFS) - H9519-003-0 Benefit Details |
Wyoming | $33.30 | $0 | Few Generics, Few Brand | Tier 1: $8.00 Tier 2: $45.00 Tier 3: $75.00 Specialty Tier 4: 33% | 79 members Browse Formulary | |||||
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Independent Health Medicare Family Choice (HMO) - H3362-020-0 Benefit Details |
Wyoming | $33.30 | $150 | No Gap Coverage | Tier 1: $5.00 Tier 2: $25.00 Tier 3: $50.00 Specialty 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 | |||||||||
Univera Medicare PPO 102 (PPO) - H3335-002-0 Benefit Details |
Wyoming | $36.00 | $150 | No Gap Coverage | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 25% | 585 members Browse Formulary | |||||
Preferred Gold (HMO) - H3305-007-0 Benefit Details |
Wyoming | $38.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 11,161 members | ||||||
Humana Gold Choice H4774-002 (PFFS) - H4774-002-0 Benefit Details |
Wyoming | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty: 33% | 716 members 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 Plan Three (PFFS) - H2762-024-0 Benefit Details |
Wyoming | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,787 members | ||||||
BlueCross BlueShield Forever Blue Medicare PPO 701 (PPO) - H5526-002-0 Benefit Details |
Wyoming | $46.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
SeniorChoice Value Plus (HMO) - H3351-012-0 Benefit Details |
Wyoming | $46.00 | $150 | No Gap Coverage | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 25% | 364 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H4774-005 (PFFS) - H4774-005-0 Benefit Details |
Wyoming | $52.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 943 members Browse Formulary | |||||
SecurityChoice Classic (PFFS) - H0540-088-0 Benefit Details |
Wyoming | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
SeniorChoice Select (HMO) - H3351-001-0 Benefit Details |
Wyoming | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,567 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Plus (PFFS) - H0540-089-0 Benefit Details |
Wyoming | $56.00 | $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% | n/a Browse Formulary | |||||
BlueCross BlueShield Senior Blue HMO 653 PartD (HMO) - H3384-041-0 Benefit Details |
Wyoming | $60.00 | $0 | Some Generics | Formulary Generic: $5.00 Preferred Brand: $40.00 Non-Preferred: 50% Specialty Injectables: 30% | 3,616 members Browse Formulary | |||||
GoldValue Rx (HMO) - H3305-015-0 Benefit Details |
Wyoming | $60.00 | $0 | No Gap Coverage | Tier 1: $9.00 Tier 2: $30.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 8,000% | 2,209 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Independent Health Medicare Passport Advantage (PPO) - H3344-005-0 Benefit Details |
Wyoming | $60.00 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $45.00 Tier 3: $75.00 Specialty Tier 4: 33% | n/a Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H3333-050-0 Benefit Details |
Wyoming | $69.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H4774-001 (PFFS) - H4774-001-0 Benefit Details |
Wyoming | $72.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 2,202 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Independent Health Medicare Passport (PPO) - H3344-001-0 Benefit Details |
Wyoming | $77.00 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $42.00 Tier 3: $75.00 Specialty Tier 4: 33% | 531 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-050-0 Benefit Details |
Wyoming | $85.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 9,959 members Browse Formulary | |||||
SeniorChoice Secure (HMO) - H3351-002-0 Benefit Details |
Wyoming | $86.00 | $0 | No Gap Coverage | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 33% | 12,682 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Independent Health Encompass 65 Extra (HMO) - H3362-004-0 Benefit Details |
Wyoming | $87.00 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $42.00 Tier 3: $65.00 Specialty Tier 4: 33% | 7,145 members Browse Formulary | |||||
BlueCross BlueShield Forever Blue Medicare PPO 751 (PPO) - H5526-004-0 Benefit Details |
Wyoming | $88.00 | $0 | No Gap Coverage | Formulary Generic: $6.50 Preferred Brand: $40.00 Non-Preferred Brand/Generic: 50% Specialty Injectables: 30% | 3,371 members Browse Formulary | |||||
Preferred Gold Rx (HMO) - H3305-011-0 Benefit Details |
Wyoming | $92.00 | $0 | No Gap Coverage | Tier 1: $9.00 Tier 2: $30.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 8,000% | 17,654 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details |
Wyoming | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Independent Health Medicare Anywhere (PFFS) - H9519-001-0 Benefit Details |
Wyoming | $135.00 | $0 | Few Generics, Few Brand | Tier 1: $8.00 Tier 2: $40.00 Tier 3: $70.00 Specialty Tier 4: 33% | 156 members Browse Formulary | |||||
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BlueCross BlueShield Forever Blue Medicare PPO 752 (PPO) - H5526-008-0 Benefit Details |
Wyoming | $142.00 | $0 | Some Generics | Formulary Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand/Generic: 50% Specialty Injectables: 30% | 2,166 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
GoldAnywhere Rx (PPO) - H3346-002-0 Benefit Details |
Wyoming | $165.00 | $0 | Many Generics | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $90.00 Tier 4: 33% Tier 5: 8,000% | n/a Browse Formulary | |||||
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Independent Health Medicare Passport Premier (PPO) - H3344-003-0 Benefit Details |
Wyoming | $167.00 | $0 | Few Generics, Few Brand | Tier 1: $4.00 Tier 2: $40.00 Tier 3: $70.00 Specialty Tier 4: 33% | 828 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
Wyoming | $170.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option I (PFFS) - H5006-014-3 Benefit Details |
Wyoming | $183.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Sterling Option IV (PFFS) - H5006-016-3 Benefit Details |
Wyoming | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
BlueCross BlueShield Forever Blue Medicare PPO 755 (PPO) - H5526-010-0 Benefit Details |
Wyoming | $265.00 | $0 | Many Generics, Many Brand | Formulary Generic: $5.00 Preferred Brand: $25.00 Non-Preferred Brand/Generic: $40.00 Specialty Injectables: 30% | n/a Browse Formulary | |||||
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