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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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Green Plan (Cost) - H0602-042-0 Benefit Details |
Kiowa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 184 members | ||||||
SecureHorizons MedicareDirect Plan 2 (PFFS) - H5435-002-0 Benefit Details |
Kiowa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 16,559 members | ||||||
SecureHorizons MedicareDirect Rx Plan 55 (PFFS) - H5435-024-0 Benefit Details |
Kiowa | $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: $80.00 Tier 4 Specialty: 33% | 54,374 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 (PFFS) - H5421-149-0 Benefit Details |
Kiowa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,299 members | ||||||
SmartValue Classic (PFFS) - H0540-090-0 Benefit Details |
Kiowa | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 11,362 members | ||||||
Today's Options Value powered by CCRx (PFFS) - H5421-150-0 Benefit Details |
Kiowa | $23.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,210 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
AB Basic Plan (Cost) - H0602-026-0 Benefit Details |
Kiowa | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Thrifty Plan (Cost) - H0602-028-0 Benefit Details |
Kiowa | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 87 members | ||||||
Green Plan + Rx (Cost) - H0602-043-0 Benefit Details |
Kiowa | $31.60 | $120 | No Gap Coverage | Generic Drugs: $12.00 Preferred Brand Drugs: $36.00 Non-Preferred Drugs: $56.00 Specialty Drugs: 30% | 435 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SmartValue Plus (PFFS) - H0540-091-0 Benefit Details |
Kiowa | $40.00 | $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% | 12,629 members Browse Formulary | |||||
Standard Plan (Cost) - H0602-007-0 Benefit Details |
Kiowa | $46.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 443 members | ||||||
Humana Gold Choice H2944-006 (PFFS) - H2944-006-0 Benefit Details |
Kiowa | $56.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 7,929 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Thrifty Plan + Rx (Cost) - H0602-038-0 Benefit Details |
Kiowa | $67.70 | $115 | No Gap Coverage | Generic Drugs: $12.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $60.00 Specialty Drugs: 30% | 102 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-147-0 Benefit Details |
Kiowa | $74.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Standard Plan + Rx (Cost) - H0602-020-0 Benefit Details |
Kiowa | $92.90 | $0 | No Gap Coverage | Generic Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Drugs: $60.00 Specialty Drugs: 33% | 2,155 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) - H5421-148-0 Benefit Details |
Kiowa | $120.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 643 members Browse Formulary | |||||
Humana Gold Choice H2944-007 (PFFS) - H2944-007-0 Benefit Details |
Kiowa | $152.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 963 members Browse Formulary | |||||
Gold Plan (Cost) - H0602-002-0 Benefit Details |
Kiowa | $156.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | < 10 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Gold Plan + Rx (Cost) - H0602-018-0 Benefit Details |
Kiowa | $242.80 | $0 | All Generics | Generic Drugs: $8.50 Preferred Brand: $38.00 Non-Preferred Brand: $58.00 Specialty Drugs: 33% | 257 members Browse Formulary | |||||
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