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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 |
Dallas | $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 | |||||
HealthSpring HealthyAdvantage (HMO) - H0150-012-0 Benefit Details |
Dallas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 799 members | ||||||
HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Dallas | $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 |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HealthSpring TotalCare (HMO) - H0150-007-0 Benefit Details |
Dallas | $ 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% | 12,752 members Browse Formulary | |||||
Blue Advantage Special Needs Plan (PPO) - H0104-006-0 Benefit Details |
Dallas | $ 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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Advantage Plus (PPO) - H0104-004-0 Benefit Details |
Dallas | $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 | |||||
HealthSpring HealthyAdvantage Select (HMO) - H0150-010-0 Benefit Details |
Dallas | $41.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | n/a Browse Formulary | |||||
SecurityChoice Classic (PFFS) - H0540-088-0 Benefit Details |
Dallas | $55.00 | 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 | |||||||||
SecurityChoice Plus (PFFS) - H0540-089-0 Benefit Details |
Dallas | $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 | |||||
HealthSpring OptimaCare (HMO) - H0150-019-0 Benefit Details |
Dallas | $65.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: 33% Specialty: 33% | 858 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-015-0 Benefit Details |
Dallas | $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 |
Dallas | $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 | |||||
Today's Options Value (PFFS) - H5421-173-0 Benefit Details |
Dallas | $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 | |||||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-034-0 Benefit Details |
Dallas | $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 | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-174-0 Benefit Details |
Dallas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-171-0 Benefit Details |
Dallas | $124.00 | 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 | |||||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-019-0 Benefit Details |
Dallas | $135.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 members | ||||||
Blue Advantage Preferred (PPO) - H0104-008-0 Benefit Details |
Dallas | $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) - H5421-172-0 Benefit Details |
Dallas | $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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