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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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(Donut Hole) Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
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AARP MedicareComplete Essential (HMO) - H0543-121-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,534 members | ||||||
AARP MedicareComplete Plan 2 (HMO) - H0543-143-0 Benefit Details |
San Diego | $0.00 | $0 | No Gap Coverage | Tier 1: tbd | n/a Browse Formulary | |||||
Aetna Medicare Select Plan (HMO) - H0523-052-0 Benefit Details |
San Diego | $0.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $7.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 427 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Blue Cross Senior Secure Plan I (HMO) - H0564-047-0 Benefit Details |
San Diego | $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% | 9,326 members Browse Formulary | |||||
Care1st Medicare Advantage Value Plan (HMO) - H5928-010-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Generic: $5.00 Brand: $30.00 Other Non-Preferred: $50.00 Specialty: 25% | 2,072 members Browse Formulary | |||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
San Diego | $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 |
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Service | Exper. | Cost Info | |||||||||
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 | ||||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
San Diego | $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 | |||||||||
Fresenius Medical Care Health Plan (PFFS) - H5301-003-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 143 members | ||||||
Health Net Healthy Heart (HMO) - H0562-012-0 Benefit Details |
San Diego | $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% | 3,613 members Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-048-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 109 members | ||||||
Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Kaiser Permanente Senior Advantage San Diego (HMO) - H0524-037-0 Benefit Details |
San Diego | $0.00 | $0 | All Generics | Generic: $10.00 Brand: $45.00 Specialty: 25% | 33,889 members Browse Formulary | |||||
Molina Medicare Options (HMO) - H5810-002-0 Benefit Details |
San Diego | $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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Aetna Medicare Open Basic Plan (PFFS) - H5736-018-0 Benefit Details |
San Diego | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 761 members | ||||||
Plan Name | County | Monthly Prem. |
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Molina Medicare Options Plus (HMO) - H5810-001-0 Benefit Details |
San Diego | $ 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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Senior Advantage Medicare Medi-Cal Plan South (HMO) - H0524-029-0 Benefit Details |
San Diego | $ 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 | |||||
AARP MedicareComplete Plan 1 (HMO) - H0543-013-0 Benefit Details |
San Diego | $25.00 | $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% | 15,431 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) - H0543-122-0 Benefit Details |
San Diego | $25.00 | $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% | 11,135 members Browse Formulary | |||||
Evercare Plan MH (HMO) - H0543-137-0 Benefit Details |
San Diego | $25.00 | $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% | 733 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H5425-005-0 Benefit Details |
San Diego | $25.00 | $0 | All Generics | Select Generic: $0.00 Generic: $7.00 Brand: $28.00 Additional Brand: $50.00 Specialty: 25% | 6,773 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Care1st Dual Plus Value Plan (HMO) - H5928-009-0 Benefit Details |
San Diego | $ 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% | 801 members Browse Formulary | |||||
CommuniCare Advantage (HMO) - H7086-001-0 Benefit Details |
San Diego | $ 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 Brand: $47.00 | 829 members Browse Formulary | |||||
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VillageHealth (HMO-POS) - H5943-001-0 Benefit Details |
San Diego | $29.00 | $0 | No Gap Coverage | Select Generic: $0.00 Generic: $6.00 Brand: $30.00 Additional Brand: $55.00 Specialty: 25% | 432 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 Seniority Plus Amber II (HMO) - H0562-070-0 Benefit Details |
San Diego | $ 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 |
San Diego | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SmartValue Classic (PFFS) - H5419-001-0 Benefit Details |
San Diego | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Aetna Medicare Open Value Plan w/Rx (PFFS) - H5736-003-0 Benefit Details |
San Diego | $44.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $34.00 Tier 4 - Non-Preferred Brand: $74.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
Aetna Medicare Premier Plan (HMO) - H0523-054-0 Benefit Details |
San Diego | $52.00 | $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 Generic: $80.00 Tier 5 - Specialty: 33% | 37 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Options Value (PFFS) - H5421-165-0 Benefit Details |
San Diego | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
AARP MedicareComplete Plan 3 (HMO) - H0543-060-0 Benefit Details |
San Diego | $69.00 | $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: $79.00 Tier 4 Specialty: 33% | 7,948 members Browse Formulary | |||||
AARP MedicareComplete Premier (HMO) - H0543-083-0 Benefit Details |
San Diego | $69.00 | $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% | 21,602 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 Seniority Plus Ruby Plan 2 (HMO) - H0562-040-0 Benefit Details |
San Diego | $69.00 | $0 | No Gap Coverage | 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% | 742 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H5425-004-0 Benefit Details |
San Diego | $69.00 | $0 | All Generics | Select Generic: $0.00 Generic: $5.00 Brand: $28.00 Additional Brand: $50.00 Specialty: 25% | n/a Browse Formulary | |||||
Humana Gold Choice H2944-033 (PFFS) - H2944-033-0 Benefit Details |
San Diego | $73.00 | $0 | Few Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 2,762 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
San Diego | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 members Browse Formulary | |||||
SmartValue Plus (PFFS) - H5419-004-0 Benefit Details |
San Diego | $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 | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-023-0 Benefit Details |
San Diego | $85.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 183 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
Health Net Violet (PPO) - H5439-001-0 Benefit Details |
San Diego | $89.00 | $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% | 740 members Browse Formulary | |||||
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CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-048-0 Benefit Details |
San Diego | $90.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | n/a Browse Formulary | |||||
Humana Gold Choice H2944-034 (PFFS) - H2944-034-0 Benefit Details |
San Diego | $101.00 | $0 | Few Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 955 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 |
San Diego | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-027-0 Benefit Details |
San Diego | $140.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 78 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
San Diego | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 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 Seniority Plus Ruby Plan 3 (HMO) - H0562-077-0 Benefit Details |
San Diego | $169.00 | $0 | No Gap Coverage | 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% | 371 members Browse Formulary | |||||
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