$dynamicTitle=$dynamicTitle.' Medicare Advantage Plans'; ?>
2010 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
AARP MedicareComplete Plan 3 (HMO) - H0316-002-0 Benefit Details |
Santa Cruz | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 11,529 members Browse Formulary | |||||
Evercare Plan MH (HMO) - H0316-013-0 Benefit Details |
Santa Cruz | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | 310 members Browse Formulary | |||||
Health Net Green (HMO) - H0351-030-0 Benefit Details |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 882 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Health Net Ruby 4 (HMO) - H0351-035-0 Benefit Details |
Santa Cruz | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Genericá: $7.00 Tier 2 Preferred Brand: $41.00 Tier 3 Non-Preferred: $82.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 3,889 members Browse Formulary | |||||
HumanaChoice R5826-070 (Regional PPO) - R5826-070-0 Benefit Details |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,334 members | ||||||
HumanaChoice R5826-070 (Regional PPO) - R5826-070-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,334 members | ||||||
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 |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,942 members | ||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Today's Options Premier (PFFS) - H5421-139-0 Benefit Details |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,721 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) - H5421-141-0 Benefit Details |
Santa Cruz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 259 members | ||||||
Mercy Care Advantage (HMO) - H5580-001-0 Benefit Details |
Santa Cruz | $ 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% | 15,233 members Browse Formulary | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Santa Cruz | $23.00 | $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% | 15,526 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Health Net Amber (HMO) - H0351-029-0 Benefit Details |
Santa Cruz | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Tier 1 Preferred Genericá: $2.00 Tier 2 Preferred Brand: $32.00 Tier 3 Non-Preferred: $75.00 Tier 4 Injectable: 25% Tier 5 Specialty: 25% | 8,570 members Browse Formulary | |||||
APIPA Personal Care Plus (HMO) - H0321-002-0 Benefit Details |
Santa Cruz | $ 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% | 17,695 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-142-0 Benefit Details |
Santa Cruz | $26.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 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 | |||||||||
Health Net Ruby 1 (HMO) - H0351-014-0 Benefit Details |
Santa Cruz | $36.00 | $0 | No Gap Coverage | Tier 1 Preferred Genericá: $6.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 29,793 members Browse Formulary | |||||
Any, Any, Any MA Only (PFFS) - H5820-029-0 Benefit Details |
Santa Cruz | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 872 members | ||||||
HumanaChoice H0317-004 (PPO) - H0317-004-0 Benefit Details |
Santa Cruz | $51.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 688 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any Gold (PFFS) - H5820-011-0 Benefit Details |
Santa Cruz | $59.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 15,561 members Browse Formulary | |||||
Health Net Ruby 3 (HMO) - H0351-034-0 Benefit Details |
Santa Cruz | $59.00 | $0 | No Gap Coverage | Tier 1 Preferred Genericá: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 5,325 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-140-0 Benefit Details |
Santa Cruz | $64.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 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 | |||||||||
HumanaChoice R5826-014 (Regional PPO) - R5826-014-0 Benefit Details |
Santa Cruz | $88.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,928 members Browse Formulary | |||||
HumanaChoice R5826-014 (Regional PPO) - R5826-014-0 Benefit Details |
Statewide | $88.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,928 members Browse Formulary | |||||
Any, Any, Any Platinum (PFFS) - H5820-013-0 Benefit Details |
Santa Cruz | $89.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 612 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 H2944-029 (PFFS) - H2944-029-0 Benefit Details |
Santa Cruz | $132.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $38.00 Non-Preferred Brand: $80.00 Specialty: 33% | 170 members Browse Formulary | |||||
HumanaChoice R5826-076 (Regional PPO) - R5826-076-0 Benefit Details |
Santa Cruz | $147.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | < 10 members Browse Formulary | |||||
HumanaChoice R5826-076 (Regional PPO) - R5826-076-0 Benefit Details |
Statewide | $147.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | < 10 members Browse Formulary | |||||
|