$dynamicTitle=$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 |
|||||||||
CareMore Touch (HMO) - H0544-022-0 Benefit Details |
Santa Clara | $0.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $30.00 Brand Drugs: $60.00 Specialty Drugs: 33% | < 10 members Browse Formulary | |||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Santa Clara | $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 |
Santa Clara | $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 | |||||
Fresenius Medical Care Health Plan (PFFS) - H5301-003-0 Benefit Details |
Santa Clara | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 143 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
StartSmart with CareMore (HMO) - H0544-021-0 Benefit Details |
Santa Clara | $19.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $40.00 Preferred Brand Drugs: $55.00 Brand Drugs: $75.00 Specialty Drugs: 33% | 64 members Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan North (HMO) - H0524-030-0 Benefit Details |
Santa Clara | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $13.00 Brand: $45.00 Specialty: 25% | 28,501 members Browse Formulary | |||||
Freedom Blue Plus (Regional PPO) - R9943-003-0 Benefit Details |
Santa Clara | $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 | |||||||||
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 |
Santa Clara | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
CareMore Value Plus (HMO) - H0544-012-0 Benefit Details |
Santa Clara | $49.00 | $0 | All Generics | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $15.00 Preferred Brand Drugs: $30.00 Brand Drugs: $60.00 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 | |||||||||
SCAN Health Plan (HMO) - H5425-024-0 Benefit Details |
Santa Clara | $49.00 | $0 | No Gap Coverage | Select Generic: $0.00 Generic: $10.00 Brand: $40.00 Additional Brand: $70.00 Specialty: 33% | 354 members Browse Formulary | |||||
Today's Options Value (PFFS) - H5421-157-0 Benefit Details |
Santa Clara | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 344 members | ||||||
CareMore Breathe (HMO) - H0544-024-0 Benefit Details |
Santa Clara | $59.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $30.00 Brand Drugs: $60.00 Specialty Drugs: 33% | 14 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CareMore Diabetes (HMO) - H0544-025-0 Benefit Details |
Santa Clara | $59.00 | $0 | No Gap Coverage | Preferred Generic Drugs: $0.00 Generic Drugs: $5.00 Enhanced Care Brand Drugs: $0.00 Preferred Brand Drugs: $30.00 Brand Drugs: $60.00 Specialty Drugs: 33% | 106 members Browse Formulary | |||||
SCAN Health Plan (HMO) - H5425-020-0 Benefit Details |
Santa Clara | $59.00 | $0 | All Generics | Select Generic: $0.00 Generic: $10.00 Brand: $30.00 Additional Brand: $50.00 Specialty: 33% | 86 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-158-0 Benefit Details |
Santa Clara | $63.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 559 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Senior Advantage Santa Clara (HMO) - H0524-039-0 Benefit Details |
Santa Clara | $74.00 | $0 | All Generics | Generic: $10.00 Brand: $45.00 Specialty: 25% | 28,077 members Browse Formulary | |||||
SmartValue Plus (PFFS) - H5419-004-0 Benefit Details |
Santa Clara | $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 | |||||
Health Net Seniority Plus Green (HMO) - H0562-045-0 Benefit Details |
Santa Clara | $79.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 584 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H2944-032 (PFFS) - H2944-032-0 Benefit Details |
Santa Clara | $83.00 | $0 | Few Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 3,921 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-155-0 Benefit Details |
Santa Clara | $84.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 703 members | ||||||
CIGNA Medicare Access Plan One (PFFS) - H2762-023-0 Benefit Details |
Santa Clara | $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 |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-048-0 Benefit Details |
Santa Clara | $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 | |||||
AARP MedicareComplete (HMO) - H0543-029-0 Benefit Details |
Santa Clara | $105.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $8.00 Tier 2 Generic Preferred Brand: $38.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | 6,893 members Browse Formulary | |||||
Health Net Healthy Heart (HMO) - H0562-037-0 Benefit Details |
Santa Clara | $119.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic: $7.00 Tier 2 Preferred Brand: $42.00 Tier 3 Non-Preferred: $84.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 3,529 members Browse Formulary | |||||
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) - H2762-027-0 Benefit Details |
Santa Clara | $140.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 78 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-156-0 Benefit Details |
Santa Clara | $146.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 225 members Browse Formulary | |||||
Humana Gold Choice H2944-072 (PFFS) - H2944-072-0 Benefit Details |
Santa Clara | $164.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 705 members Browse Formulary | |||||
|