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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AARP MedicareComplete Plus (HMO-POS) - H3456-001-0 Benefit Details |
Davidson | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 34,586 members Browse Formulary | |||||
AARP MedicareComplete Plus Essential (HMO-POS) - H3456-020-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Blue Medicare HMO Medical Only (HMO) - H3449-012-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,286 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare HMO Standard (HMO) - H3449-013-0 Benefit Details |
Davidson | $0.00 | $0 | No Gap Coverage | Tier 1 - Generics: $7.00 Tier 2 - Preferred brand: $40.00 Tier 3 - Non-preferred brand: $80.00 Tier 4 - Specialty: 33% | 5,342 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-020-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 13,290 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-042-0 Benefit Details |
Davidson | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Evercare Plan MH (HMO) - H3456-022-0 Benefit Details |
Davidson | $0.00 | $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% | 16,341 members Browse Formulary | |||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Patriot (PFFS) - H0979-004-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 755 members | ||||||
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Patriot Plus (PFFS) - H0979-005-0 Benefit Details |
Davidson | $0.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $45.00 Tier 3: $75.00 Tier 4: 33% | 4,137 members Browse Formulary | |||||
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Presidential (PFFS) - H0979-006-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 294 members | ||||||
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Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Plan 3 (PFFS) - H5435-003-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,942 members | ||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Today's Options Value (PFFS) - H5421-053-0 Benefit Details |
Davidson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 7,273 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Advantage 2 powered by CCRx (PPO) - H5378-191-0 Benefit Details |
Davidson | $11.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
Humana Gold Choice H2944-134 (PFFS) - H2944-134-0 Benefit Details |
Davidson | $20.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 491 members Browse Formulary | |||||
Presidential Plus (PFFS) - H0979-007-0 Benefit Details |
Davidson | $21.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $39.00 Tier 3: $69.00 Tier 4: 33% | n/a 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-071-0 Benefit Details |
Davidson | $21.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 9,163 members Browse Formulary | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Davidson | $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 | |||||
Evercare Plan DH (HMO) - H3456-016-0 Benefit Details |
Davidson | $ 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% | 7,635 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 IH (HMO) - H3456-010-0 Benefit Details |
Davidson | $34.90 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Fidelis Secure Comfort (HMO) - H5575-005-0 Benefit Details |
Davidson | $34.90 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 363 members Browse Formulary | |||||
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Today's Options Advantage 1 powered by CCRx (PPO) - H5378-187-0 Benefit Details |
Davidson | $39.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 256 members Browse Formulary | |||||
new | new | new | |||||||||
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) - H5421-047-0 Benefit Details |
Davidson | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,082 members | ||||||
Humana Gold Choice H2944-133 (PFFS) - H2944-133-0 Benefit Details |
Davidson | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 23,180 members Browse Formulary | |||||
AARP MedicareComplete Choice (PPO) - H5516-001-0 Benefit Details |
Davidson | $45.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 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 | |||||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-024-0 Benefit Details |
Davidson | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,787 members | ||||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Statewide | $56.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 727 members Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Davidson | $56.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 727 members 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 Advantage 3 powered by CCRx (PPO) - H5378-183-0 Benefit Details |
Davidson | $67.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 173 members Browse Formulary | |||||
new | new | new | |||||||||
Fidelis Secure Comfort Plus (HMO) - H5575-006-0 Benefit Details |
Davidson | $70.00 | $0 | No Gap Coverage | generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $65.00 Specialty: 33% | < 10 members Browse Formulary | |||||
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HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Davidson | $72.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $85.00 Specialty: 33% | 3,887 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Statewide | $72.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $85.00 Specialty: 33% | 3,887 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-065-0 Benefit Details |
Davidson | $77.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,790 members Browse Formulary | |||||
Blue Medicare HMO Enhanced (HMO) - H3449-005-0 Benefit Details |
Davidson | $80.90 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 22,396 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 Plus RX Plan Four (PFFS) - H2762-050-0 Benefit Details |
Davidson | $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 | |||||
Fidelis Secure Independence (HMO) - H5575-007-0 Benefit Details |
Davidson | $85.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred: $65.00 Specialty: 33% | 38 members Browse Formulary | |||||
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Blue Medicare PPO Enhanced (PPO) - H3404-001-0 Benefit Details |
Davidson | $97.60 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 2,643 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 |
Davidson | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Blue Medicare PPO Enhanced Freedom (PPO) - H3404-002-0 Benefit Details |
Davidson | $147.50 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 3,311 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
Davidson | $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 |
Davidson | $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 |
Davidson | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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