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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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Aetna Medicare Value Plan (HMO) - H3623-001-0 Benefit Details |
Lucas | $0.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $33.00 Tier 4 - Non-Preferred Brand: $78.00 Tier 5 - Specialty: 25% | 2,359 members Browse Formulary | |||||
Anthem Senior Advantage Basic (HMO) - H3655-013-0 Benefit Details |
Lucas | $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 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Lucas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 995 members | ||||||
Blue Medicare Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Lucas | $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 |
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 | |||||
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 |
Lucas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,037 members | ||||||
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 | ||||||
Paramount Elite - Standard Medical and Drug (HMO) - H3653-015-0 Benefit Details |
Lucas | $21.00 | $0 | No Gap Coverage | Tier 1 - Generic: $10.00 Tier 2 - Brand: $40.00 Tier 3 - Part D Eligible Injectables: 33% Tier 4 - Specialty Drugs: 33% | 478 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 |
Lucas | $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 |
Lucas | $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 |
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 | |||||
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 |
Lucas | $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 |
Lucas | $ 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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CareSource Advantage (HMO) - H6178-001-0 Benefit Details |
Lucas | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Tier 1: $0.00 Tier 2: $45.00 Tier 3: 25% Tier 4: $98.00 | 654 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 | |||||||||
Evercare Plan IH-POS (HMO-POS) - H3659-058-0 Benefit Details |
Lucas | $30.50 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 184 members Browse Formulary | |||||
Anthem Medicare Preferred Select (PPO) - H5529-004-0 Benefit Details |
Lucas | $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 | |||||
Aetna Medicare Open Basic Plan (PFFS) - H5736-020-0 Benefit Details |
Lucas | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 296 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H3619-013 (PPO) - H3619-013-0 Benefit Details |
Lucas | $50.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 2,054 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-014-0 Benefit Details |
Lucas | $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 |
Lucas | $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 |
Statewide | $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 |
Lucas | $61.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 181 members Browse Formulary | |||||
Paramount Elite - Enhanced Medical only (HMO) - H3653-018-0 Benefit Details |
Lucas | $64.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 155 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 |
Lucas | $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 |
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 | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-032-0 Benefit Details |
Lucas | $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 | |||||||||
Aetna Medicare Premier Plan (HMO) - H3623-003-0 Benefit Details |
Lucas | $74.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $28.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - Non-Preferred Brand: $75.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Open Value Plan w/Rx (PFFS) - H5736-025-0 Benefit Details |
Lucas | $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 | |||||
Today's Options Value (PFFS) - H5421-173-0 Benefit Details |
Lucas | $85.00 | 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 | |||||||||
Paramount Elite - Enhanced Medical and Drug (HMO) - H3653-004-0 Benefit Details |
Lucas | $99.00 | $0 | No Gap Coverage | Tier 1 - Generic: $7.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-Preferred Brand: $80.00 Tier 4 - Multisource Brand and Isomerics: $80.00 Tier 5 - Part D Eligible Injectables: 33% Tier 6 - Specialty Drugs: 33% | 12,479 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-174-0 Benefit Details |
Lucas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Aetna Medicare Standard Plan (PPO) - H5521-020-0 Benefit Details |
Lucas | $103.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $34.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 261 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) - H2762-018-0 Benefit Details |
Lucas | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 151 members | ||||||
Today's Options Premier (PFFS) - H5421-171-0 Benefit Details |
Lucas | $124.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-040-0 Benefit Details |
Lucas | $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 | |||||||||
Advantage Plan Optimumx (HMO-POS) - H9313-012-1 Benefit Details |
Lucas | $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 | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-172-0 Benefit Details |
Lucas | $186.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
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