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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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Anthem Senior Advantage Basic (HMO) - H3655-013-0 Benefit Details |
Ashtabula | $0.00 | $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% | 69,004 members Browse Formulary | |||||
Blue Medicare Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 995 members | ||||||
Blue Medicare Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Ashtabula | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 995 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Statewide | $0.00 | $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% | 14,988 members Browse Formulary | |||||
Blue Medicare Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Ashtabula | $0.00 | $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% | 14,988 members Browse Formulary | |||||
HumanaChoice R5826-021 (Regional PPO) - R5826-021-0 Benefit Details |
Ashtabula | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,037 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-021 (Regional PPO) - R5826-021-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,037 members | ||||||
SummaCare Secure Classic Medical Only (HMO-POS) - H3660-043-0 Benefit Details |
Ashtabula | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 51 members | ||||||
SummaCare Secure Silver Plus (HMO-POS) - H3660-029-0 Benefit Details |
Ashtabula | $0.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 33% | 10,618 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Anthem Senior Advantage Plus (HMO) - H3655-030-0 Benefit Details |
Ashtabula | $22.00 | $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 Injectible Drugs: 33% Tier 5 Specialty Drugs: 33% | 7,719 members Browse Formulary | |||||
Anthem Medicare Preferred Standard (PPO) - H5529-001-0 Benefit Details |
Ashtabula | $28.00 | $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% | 8,307 members Browse Formulary | |||||
Blue Medicare Access Standard (Regional PPO) - R5941-001-0 Benefit Details |
Ashtabula | $30.00 | $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% | 14,803 members 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) - R5941-001-0 Benefit Details |
Statewide | $30.00 | $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% | 14,803 members Browse Formulary | |||||
Buckeye Community Health Plan (HMO) - H0908-001-0 Benefit Details |
Ashtabula | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Injectables: $95.00 | 233 members Browse Formulary | |||||
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Anthem Medicare Preferred Select (PPO) - H5529-004-0 Benefit Details |
Ashtabula | $49.00 | $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% | 4,701 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Aetna Medicare Open Basic Plan (PFFS) - H5736-020-0 Benefit Details |
Ashtabula | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 296 members | ||||||
CIGNA Medicare Access Plan One (PFFS) - H2762-014-0 Benefit Details |
Ashtabula | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 215 members | ||||||
Advantage Plan Securex (HMO-POS) - H9313-007-0 Benefit Details |
Ashtabula | $58.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Non-Preferred Generic: $15.00 Preferred Brand: $50.00 Non-Preferred Brand: $90.00 Specialty: 33% | 911 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-080 (Regional PPO) - R5826-080-0 Benefit Details |
Ashtabula | $61.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 181 members Browse Formulary | |||||
HumanaChoice R5826-080 (Regional PPO) - R5826-080-0 Benefit Details |
Statewide | $61.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 181 members Browse Formulary | |||||
Today's Options Value (PFFS) - H5421-165-0 Benefit Details |
Ashtabula | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-007 (Regional PPO) - R5826-007-0 Benefit Details |
Statewide | $69.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $82.00 Specialty: 33% | 7,690 members Browse Formulary | |||||
HumanaChoice R5826-007 (Regional PPO) - R5826-007-0 Benefit Details |
Ashtabula | $69.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $82.00 Specialty: 33% | 7,690 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-032-0 Benefit Details |
Ashtabula | $70.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 942 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 Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Ashtabula | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 members Browse Formulary | |||||
Aetna Medicare Open Value Plan w/Rx (PFFS) - H5736-025-0 Benefit Details |
Ashtabula | $78.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $38.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 931 members Browse Formulary | |||||
SummaCare Secure Gold Plus (HMO-POS) - H3660-028-0 Benefit Details |
Ashtabula | $80.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | 7,381 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 Premier (PFFS) - H5421-163-0 Benefit Details |
Ashtabula | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-018-0 Benefit Details |
Ashtabula | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 151 members | ||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-040-0 Benefit Details |
Ashtabula | $145.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 254 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 Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Ashtabula | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
Advantage Plan Optimumx (HMO-POS) - H9313-012-1 Benefit Details |
Ashtabula | $170.00 | $0 | Many Generics | Preferred Generic: $4.00 Non-Preferred Generic: $15.00 Preferred Brand: $50.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | 319 members Browse Formulary | |||||
SummaCare Secure Platinum (HMO-POS) - H3660-032-0 Benefit Details |
Ashtabula | $180.00 | $0 | All Generics | Tier 1: $3.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 33% | 917 members Browse Formulary | |||||
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