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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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CIGNA Medicare Access Plan One (PFFS) - H2762-020-0 Benefit Details |
Stanislaus | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 13,290 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-042-0 Benefit Details |
Stanislaus | $0.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 40,257 members Browse Formulary | |||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Stanislaus | $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 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 |
Stanislaus | $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 | |||||||||
Kaiser Permanente Senior Advantage Basic Stanis (HMO) - H0524-041-0 Benefit Details |
Stanislaus | $0.00 | $0 | All Generics | Generic: $10.00 Brand: $35.00 Specialty: 25% | 176 members Browse Formulary | |||||
SecureHorizons MedicareDirect Plan 2 (PFFS) - H5435-002-0 Benefit Details |
Stanislaus | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 16,559 members | ||||||
SecureHorizons MedicareDirect Rx Plan 55 (PFFS) - H5435-024-0 Benefit Details |
Stanislaus | $0.00 | $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: $80.00 Tier 4 Specialty: 33% | 54,374 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
StartSmart with CareMore (HMO) - H0544-028-0 Benefit Details |
Stanislaus | $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% | 56 members Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan North (HMO) - H0524-030-0 Benefit Details |
Stanislaus | $ 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 |
Stanislaus | $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 |
Stanislaus | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-024-0 Benefit Details |
Stanislaus | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,787 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CareMore Value Plus (HMO) - H0544-027-0 Benefit Details |
Stanislaus | $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% | 941 members Browse Formulary | |||||
CareMore Breathe (HMO) - H0544-031-0 Benefit Details |
Stanislaus | $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% | 51 members Browse Formulary | |||||
CareMore Diabetes (HMO) - H0544-032-0 Benefit Details |
Stanislaus | $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% | 241 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 Enhanced Stanis (HMO) - H0524-040-0 Benefit Details |
Stanislaus | $60.00 | $0 | All Generics | Generic: $7.00 Brand: $35.00 Specialty: 25% | 3,791 members Browse Formulary | |||||
SmartValue Plus (PFFS) - H5419-004-0 Benefit Details |
Stanislaus | $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 |
Stanislaus | $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 | |||||||||
AARP MedicareComplete (HMO) - H0543-036-0 Benefit Details |
Stanislaus | $85.00 | $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% | 12,614 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-050-0 Benefit Details |
Stanislaus | $85.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 9,959 members Browse Formulary | |||||
Today's Options Value (PFFS) - H5421-173-0 Benefit Details |
Stanislaus | $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 | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-174-0 Benefit Details |
Stanislaus | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Health Net Healthy Heart (HMO) - H0562-060-0 Benefit Details |
Stanislaus | $109.00 | $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% | 235 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-171-0 Benefit Details |
Stanislaus | $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 | |||||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-172-0 Benefit Details |
Stanislaus | $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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