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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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Blue Advantage Value (PPO) - H0104-002-0 Benefit Details |
Bullock | $0.00 | $0 | No Gap Coverage | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $35.00 Tier 4: $60.00 Tier 5: 33% | 6,513 members Browse Formulary | |||||
HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Bullock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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 | |||||||||
SecureHorizons MedicareDirect Plan 3 (PFFS) - H5435-003-0 Benefit Details |
Bullock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,942 members | ||||||
VIVA Medicare Plus Rx (HMO) - H0154-001-0 Benefit Details |
Bullock | $0.00 | $265 | No Gap Coverage | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $55.00 Tier 4: 26% | 17,855 members Browse Formulary | |||||
VIVA Medicare Plus Select (HMO) - H0154-008-0 Benefit Details |
Bullock | $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 | |||||||||
Blue Advantage Special Needs Plan (PPO) - H0104-006-0 Benefit Details |
Bullock | $ 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% Tier 5: 25% | 5,978 members Browse Formulary | |||||
VIVA Medicare Plus Rx Extra Care (HMO) - H0154-010-0 Benefit Details |
Bullock | $ 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% | 6,405 members Browse Formulary | |||||
Blue Advantage Plus (PPO) - H0104-004-0 Benefit Details |
Bullock | $41.00 | $0 | Few Generics | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $35.00 Tier 4: $60.00 Tier 5: 33% | 31,134 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Classic (PFFS) - H0540-088-0 Benefit Details |
Bullock | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
SecurityChoice Plus (PFFS) - H0540-089-0 Benefit Details |
Bullock | $56.00 | $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% | n/a Browse Formulary | |||||
Today's Options Value (PFFS) - H5421-165-0 Benefit Details |
Bullock | $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 | |||||||||
VIVA Medicare Plus Rx Premier (HMO) - H0154-011-0 Benefit Details |
Bullock | $71.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $55.00 Tier 4: 33% | 2,513 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Bullock | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-015-0 Benefit Details |
Bullock | $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 |
Bullock | $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 |
Statewide | $80.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,238 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-034-0 Benefit Details |
Bullock | $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 | |||||
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 |
Bullock | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
VIVA Medicare Plus Rx Gold (HMO) - H0154-013-0 Benefit Details |
Bullock | $127.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $55.00 Tier 4: 33% | 2,767 members Browse Formulary | |||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-019-0 Benefit Details |
Bullock | $135.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Advantage Preferred (PPO) - H0104-008-0 Benefit Details |
Bullock | $142.00 | $0 | Few Generics | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $40.00 Tier 4: $60.00 Tier 5: 33% | 15,423 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Bullock | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
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