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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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AARP MedicareComplete Plan 1 (HMO) - H4456-013-0 Benefit Details |
Scott | $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% | 8,805 members Browse Formulary | |||||
BlueAdvantage Sapphire (PPO) - H7917-007-0 Benefit Details |
Scott | $0.00 | $0 | No Gap Coverage | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $65.00 Tier 5: 33% | 3,086 members Browse Formulary | |||||
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HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Statewide | $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 | |||||||||
HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Scott | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Windsor Medicare Extra Emerald Plan (HMO) - H5698-062-0 Benefit Details |
Scott | $0.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Silver Plan (HMO) - H5698-035-0 Benefit Details |
Scott | $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 | |||||||||
BlueAdvantage Basic (PFFS) - H4979-001-3 Benefit Details |
Scott | $13.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 430 members | ||||||
Windsor Medicare Extra Gold Plan (HMO) - H5698-036-0 Benefit Details |
Scott | $25.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | 3,309 members Browse Formulary | |||||
Humana Gold Plus H4461-015 (HMO) - H4461-015-0 Benefit Details |
Scott | $26.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 7,186 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
AmeriChoice Secure Plus Complete (HMO) - H0251-001-0 Benefit Details |
Scott | $ 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% | 9,681 members Browse Formulary | |||||
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Humana Gold Choice H2944-093 (PFFS) - H2944-093-0 Benefit Details |
Scott | $36.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 422 members Browse Formulary | |||||
Humana Gold Plus H4461-004 (HMO) - H4461-004-0 Benefit Details |
Scott | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,014 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H4408-007 (PPO) - H4408-007-0 Benefit Details |
Scott | $55.00 | $0 | Few Generics, Few Brand | Preferred Generic: $6.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 571 members Browse Formulary | |||||
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Sterling Basic Plus (PFFS) - H5006-018-2 Benefit Details |
Scott | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
AARP MedicareComplete Essential (HMO) - H4456-020-0 Benefit Details |
Scott | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 426 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) - H5421-165-0 Benefit Details |
Scott | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
Windsor Medicare Extra Fusion Plan (HMO) - H5698-141-0 Benefit Details |
Scott | $74.00 | $0 | No Gap Coverage | Tier 1- Preferred Generic or Brand: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $25.00 Tier 4 - Non-Preferred Brand/Non-Preferred Generic: $45.00 Tier 5 - Specialty: 33% | 219 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Scott | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
BlueAdvantage Classic (PFFS) - H4979-003-4 Benefit Details |
Scott | $77.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,111 members | ||||||
BlueAdvantage Ruby (PPO) - H7917-014-0 Benefit Details |
Scott | $77.00 | $0 | No Gap Coverage | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $30.00 Tier 4: $55.00 Tier 5: 33% | 852 members Browse Formulary | |||||
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CIGNA Medicare Access Plan One (PFFS) - H2762-015-0 Benefit Details |
Scott | $80.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 150 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-001 (Regional PPO) - R5826-001-0 Benefit Details |
Statewide | $80.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,238 members Browse Formulary | |||||
HumanaChoice R5826-001 (Regional PPO) - R5826-001-0 Benefit Details |
Scott | $80.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,238 members Browse Formulary | |||||
BlueAdvantage Gold (PFFS) - H5884-003-2 Benefit Details |
Scott | $81.00 | $0 | No Gap Coverage | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $30.00 Tier 4: $55.00 Tier 5: 33% | 4,354 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 H2944-092 (PFFS) - H2944-092-0 Benefit Details |
Scott | $84.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 6,467 members Browse Formulary | |||||
AARP MedicareComplete Plan 2 (HMO) - H4456-019-0 Benefit Details |
Scott | $85.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 18,907 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-2 Benefit Details |
Scott | $94.00 | 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 | |||||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-034-0 Benefit Details |
Scott | $95.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 627 members Browse Formulary | |||||
Humana Gold Plus H4461-001 (HMO) - H4461-001-0 Benefit Details |
Scott | $96.00 | $0 | Few Generics, Few Brand | Preferred Generic: $6.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 33,719 members Browse Formulary | |||||
AARP MedicareComplete Plan 3 (HMO) - H4456-021-0 Benefit Details |
Scott | $99.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $39.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $74.00 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) - H5421-163-0 Benefit Details |
Scott | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
Sterling Option II (PFFS) - H5006-017-2 Benefit Details |
Scott | $107.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
BlueAdvantage Diamond (PPO) - H7917-010-0 Benefit Details |
Scott | $117.00 | $0 | No Gap Coverage | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $30.00 Tier 4: $55.00 Tier 5: 33% | 5,327 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 | |||||||||
Sterling Option IV (PFFS) - H5006-016-2 Benefit Details |
Scott | $120.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
Windsor Medicare Extra Diabetes Plan (HMO) - H5698-156-0 Benefit Details |
Scott | $132.00 | $0 | No Gap Coverage | Tier 1- Preferred Generic or Brand: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $25.00 Tier 4 - Non-Preferred Brand/Non-Preferred Generic: $45.00 Tier 5 - Specialty: 33% | 96 members Browse Formulary | |||||
BlueAdvantage Platinum (PFFS) - H5884-004-2 Benefit Details |
Scott | $133.00 | $0 | No Gap Coverage | Tier 1: $2.00 Tier 2: $10.00 Tier 3: $30.00 Tier 4: $55.00 Tier 5: 33% | 12,199 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) - H2762-019-0 Benefit Details |
Scott | $135.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 members | ||||||
Windsor Medicare Extra Diamond Plan (HMO) - H5698-068-0 Benefit Details |
Scott | $138.00 | $0 | Few Generics | Tier 1- Preferred Generic: $5.00 Tier 2 - Generic or Brand: $10.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - NonPreferred Brand/NonPreferred Generic: $60.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Scott | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 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 Plus H4461-016 (HMO) - H4461-016-0 Benefit Details |
Scott | $187.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 925 members Browse Formulary | |||||
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