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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) |
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AARP MedicareComplete Essential (HMO) - H0543-121-0 Benefit Details |
Los Angeles | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,534 members | ||||||
AARP MedicareComplete Plan 1 (HMO) - H0543-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 22,120 members Browse Formulary | |||||
AARP MedicareComplete Plan 3 (HMO) - H0543-129-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics, Some Brand | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | 23,144 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
AARP MedicareComplete Value (HMO) - H0543-077-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | 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% | 16,868 members Browse Formulary | |||||
Advantage I MAPD (HMO) - H7731-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics, All Brand | Tier 1: $0.00 Tier 2: $15.00 Tier 3: $50.00 Tier 4: 25% | 10,747 members Browse Formulary | |||||
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Advantage Select MA (HMO) - H7731-007-0 Benefit Details |
Los Angeles | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 127 members | ||||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Aetna Medicare Select Plan (HMO) - H0523-002-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | 8,535 members Browse Formulary | |||||
Blue Cross Senior Secure Plan I (HMO) - H0564-006-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 4,099 members Browse Formulary | |||||
Blue Shield 65 Plus (HMO) - H0504-015-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics, Some Brand | Formulary Generic: $5.00 Formulary Brand: $35.00 Non-Preferred Brand: $68.00 Injectables: 33% Formulary Specialty (Unique High Cost Drugs): 33% | 37,259 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Shield 65 Plus Choice Plan (HMO) - H0504-021-0 Benefit Details |
Los Angeles (Partial) | $0.00 | $0 | Many Generics, Some Brand | Formulary Generic and Insulin: $0.00 Formulary Brand: $20.00 Non-Preferred Brand: $60.00 Injectables: 33% Formulary Specialty (Unique High Cost Drugs): 33% | 2,612 members Browse Formulary | |||||
Care1st Medicare Advantage Gold Plan (HMO) - H5928-013-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Generic: $5.00 Brand: $30.00 Other Non-Preferred: $50.00 Specialty: 25% | < 10 members Browse Formulary | |||||
Care1st Medicare Advantage Platinum Plan (HMO) - H5928-004-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Generic: $5.00 Brand: $30.00 Other Non-Preferred: $50.00 Specialty: 25% | 2,251 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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CareMore Breathe (HMO) - H0544-014-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $50.00 Specialty Drugs: 33% | n/a Browse Formulary | |||||
CareMore Connect (HMO) - H0544-003-0 Benefit Details |
Los Angeles | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $0.00 Enhanced Care Brand Drugs: 25% Preferred Brand Drugs: 25% Brand Drugs: 25% Specialty Drugs: 25% | 434 members Browse Formulary | |||||
CareMore Diabetes (HMO) - H0544-004-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $50.00 Specialty Drugs: 33% | 7,095 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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CareMore ESRD (HMO) - H0544-015-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $50.00 Specialty Drugs: 33% | 661 members Browse Formulary | |||||
CareMore Heart (HMO) - H0544-013-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $50.00 Specialty Drugs: 33% | 992 members Browse Formulary | |||||
CareMore Touch (HMO) - H0544-005-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $50.00 Specialty Drugs: 25% | 804 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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CareMore Value Plus (HMO) - H0544-002-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics, All Brand | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $25.00 Brand Drugs: $60.00 Specialty Drugs: 33% | 20,564 members Browse Formulary | |||||
Central Health Medicare Plan (HMO) - H5649-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics, All Brand | Generic: $0.00 Preferred Brand: $20.00 Brand: $40.00 Specialty Drugs: 33% | 4,598 members Browse Formulary | |||||
Central Health Medicare Value Plan (HMO) - H5649-003-0 Benefit Details |
Los Angeles | $0.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | < 10 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Citizens Choice Healthplan (HMO) - H3815-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Formulary Generic Tier 1: $0.00 Formulary Preferred Brand Tier 2: $20.00 Formulary Non-Preferred Brand Tier 3: $40.00 Injectable Drugs Tier 4: 33% Specialty Drugs Tier 5: 33% | 9,506 members Browse Formulary | |||||
Easy Choice Best Plan (HMO) - H5087-005-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Preferred Generic: $5.00 Preferred Brand: $25.00 Non-Preferred Brand: $80.00 Specialty: 25% | 2,349 members Browse Formulary | |||||
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Evercare Plan MH (HMO) - H0543-133-0 Benefit Details |
Los Angeles | $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: $79.00 Tier 4 Specialty: 33% | 955 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Los Angeles | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Los Angeles (Partial) | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 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 | |||||||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 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 | |||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Los Angeles (Partial) | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 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 | |||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Statewide | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Health Net Healthy Heart Plan 1 (HMO) - H0562-082-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 25,075 members Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-044-0 Benefit Details |
Los Angeles | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 298 members | ||||||
Health Net Seniority Plus Ruby Plan 1 (HMO) - H0562-083-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 7,948 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Inter Valley Health Plan Focus SNP (HMO) - H0545-009-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Other Special Needs: $18.00 Preferred Brand: $29.00 Non-Preferred Brand: $55.00 Injectables: 10% | 634 members Browse Formulary | |||||
Inter Valley Health Plan Service To Seniors (HMO) - H0545-001-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $12.00 Preferred Brand: $29.00 Non-Preferred Brand: $60.00 Injectables: 10% Specialty Drugs: 25% | 10,926 members Browse Formulary | |||||
Inter Valley Health Plan Total Fit (HMO) - H0545-011-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic: $10.00 Non-Preferred Generic: $14.00 Preferred Brand: $39.50 Non-Preferred Brand: $49.00 Injectables: 10% Specialty Drugs: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO) - H0524-003-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics | Generic: $5.00 Brand: $35.00 Specialty: 25% | 100,776 members Browse Formulary | |||||
Molina Medicare Options (HMO) - H5810-002-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 Specialty Drug: 33% | 234 members Browse Formulary | |||||
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POSITIVE HEALTHCARE PARTNERS (HMO) - H5852-001-0 Benefit Details |
Los Angeles | $0.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 708 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Salud Con Health Net Medicare Advantage (HMO) - H0562-085-0 Benefit Details |
Los Angeles | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 381 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H9104-006-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Select Generic: $0.00 Generic: $5.00 Brand: $32.00 Additional Brand: $60.00 Specialty: 25% | 30,886 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H5425-006-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics | Select Generic: $0.00 Generic: $5.00 Brand: $32.00 Additional Brand: $60.00 Specialty: 25% | 9,713 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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SCAN Health Plan (HMO) - H5425-013-0 Benefit Details |
Los Angeles | $0.00 | $0 | All Generics | Select Generic: $0.00 Generic: $10.00 Brand: $40.00 Additional Brand: $70.00 Specialty: 33% | 3,992 members Browse Formulary | |||||
StartSmart with CareMore (HMO) - H0544-007-0 Benefit Details |
Los Angeles | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $5.00 Generic Drugs: $8.00 Enhanced Care Brand Drugs: $25.00 Preferred Brand Drugs: $35.00 Brand Drugs: $65.00 Specialty Drugs: 33% | 493 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H9104-013-0 Benefit Details |
Los Angeles | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Select Generic: $0.00 Generic: $0.00 Brand: $34.00 Additional Brand: $83.00 Specialty: 25% | 518 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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Preferred Pharmacy Copay/ Coinsurance |
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Care1st Medicare Advantage Value Plan (HMO) - H5928-002-0 Benefit Details |
Los Angeles | $10.00 | $0 | Many Generics | Preferred Generic: $0.00 Generic: $5.00 Brand: $30.00 Other Non-Preferred: $50.00 Specialty: 25% | 2,409 members Browse Formulary | |||||
Care1st Dual Plus Value Plan (HMO) - H5928-001-0 Benefit Details |
Los Angeles | $ 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% | 2,063 members Browse Formulary | |||||
Molina Medicare Options Plus (HMO) - H5810-001-0 Benefit Details |
Los Angeles | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty: 25% | 2,130 members Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
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Evercare Plan DH (HMO) - H0543-078-0 Benefit Details |
Los Angeles | $ 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% | 2,301 members Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan South (HMO) - H0524-029-0 Benefit Details |
Los Angeles | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $12.00 Brand: $43.00 Specialty: 25% | 29,811 members Browse Formulary | |||||
Easy Choice Freedom Plan (HMO) - H5087-001-0 Benefit Details |
Los Angeles | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Preferred Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 25% | 3,445 members Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
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Central Health Medi-Medi Plan (HMO) - H5649-002-0 Benefit Details |
Los Angeles | $ 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% | n/a Browse Formulary | |||||
Preferred Dual SNP (HMO) - H7731-008-0 Benefit Details |
Los Angeles | $ 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% | 863 members Browse Formulary | |||||
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Brand New Day (HMO) - H0838-020-0 Benefit Details |
Los Angeles | $29.00 | $310 | No Gap Coverage | Tier 1: 25% | n/a Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
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Health Net Seniority Plus Amber I (HMO) - H0562-055-0 Benefit Details |
Los Angeles | $ 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% | n/a Browse Formulary | |||||
Health Net Seniority Plus Amber II (HMO) - H0562-070-0 Benefit Details |
Los Angeles | $ 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% | 12,528 members Browse Formulary | |||||
Freedom Blue Plus (Regional PPO) - R9943-003-0 Benefit Details |
Los Angeles | $31.00 | $0 | Many Generics | Preferred Generic Drugs: $7.00 Preferred Brand Certain Generic Drugs: $43.00 Non-Preferred Brand Certain Generic Drugs: $85.00 Non-Specialty Injectable Drugs: 33% Specialty Drugs: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Freedom Blue Plus (Regional PPO) - R9943-003-0 Benefit Details |
Los Angeles (Partial) | $31.00 | $0 | Many Generics | Preferred Generic Drugs: $7.00 Preferred Brand Certain Generic Drugs: $43.00 Non-Preferred Brand Certain Generic Drugs: $85.00 Non-Specialty Injectable Drugs: 33% Specialty Drugs: 33% | n/a Browse Formulary | |||||
Freedom Blue Plus (Regional PPO) - R9943-003-0 Benefit Details |
Statewide | $31.00 | $0 | Many Generics | Preferred Generic Drugs: $7.00 Preferred Brand Certain Generic Drugs: $43.00 Non-Preferred Brand Certain Generic Drugs: $85.00 Non-Specialty Injectable Drugs: 33% Specialty Drugs: 33% | n/a Browse Formulary | |||||
SmartValue Classic (PFFS) - H5419-001-0 Benefit Details |
Los Angeles | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
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Health Net Healthy Heart Plan 2 (HMO) - H0562-071-0 Benefit Details |
Los Angeles | $39.00 | $0 | Many Generics | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 415 members Browse Formulary | |||||
Health Net Seniority Plus Ruby Plan 2 (HMO) - H0562-002-0 Benefit Details |
Los Angeles | $39.00 | $0 | Many Generics | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 481 members Browse Formulary | |||||
My Choice (HMO-POS) - H5425-025-0 Benefit Details |
Los Angeles | $40.00 | $0 | All Generics | Select Generic: $0.00 Generic: $5.00 Brand: $32.00 Additional Brand: $60.00 Specialty: 33% | 46 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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AARP MedicareComplete Plan 2 (HMO) - H0543-065-0 Benefit Details |
Los Angeles | $45.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | n/a Browse Formulary | |||||
SmartValue Plus (PFFS) - H5419-004-0 Benefit Details |
Los Angeles | $78.00 | $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% | 2,559 members Browse Formulary | |||||
Today's Options Value (PFFS) - H5421-181-0 Benefit Details |
Los Angeles | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 962 members | ||||||
Plan Name | County | Monthly Prem. |
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Today's Options Value powered by CCRx (PFFS) - H5421-182-0 Benefit Details |
Los Angeles | $114.00 | $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) - H5421-179-0 Benefit Details |
Los Angeles | $134.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-180-0 Benefit Details |
Los Angeles | $203.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 735 members Browse Formulary | |||||
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