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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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Bravo Achieve (HMO) - H2108-029-0 Benefit Details |
District of Columbia | $0.00 | $0 | No Gap Coverage | Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 33% Preferred Diabetic Drugs: $0.00 | 74 members Browse Formulary | |||||
Bravo Classic (HMO) - H2108-028-0 Benefit Details |
District of Columbia | $0.00 | $0 | No Gap Coverage | Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 33% | 622 members Browse Formulary | |||||
Bravo Gold (HMO) - H2108-021-0 Benefit Details |
District of Columbia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 393 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Kaiser Permanente Medicare Plus Basic no D AB (Cost) - H2150-017-0 Benefit Details |
District of Columbia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Kaiser Permanente Medicare Plus Std w/D AB (Cost) - H2150-009-0 Benefit Details |
District of Columbia | $0.00 | $0 | No Gap Coverage | Generic: $10.00 Brand: $47.00 Specialty: 25% | 3,418 members Browse Formulary | |||||
Kaiser Permanente Medicare Plus Std w/o D AB (Cost) - H2150-022-0 Benefit Details |
District of Columbia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 479 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Bravo Select (HMO) - H2108-001-0 Benefit Details |
District of Columbia | $ 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% | 4,487 members Browse Formulary | |||||
Evercare Plan DP (PPO) - H2111-008-0 Benefit Details |
District of Columbia | $ 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% | 438 members Browse Formulary | |||||
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Bravo Traditions (HMO) - H2108-020-0 Benefit Details |
District of Columbia | $33.70 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 516 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Evercare Plan IP (PPO) - H2111-001-0 Benefit Details |
District of Columbia | $33.70 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 2,468 members Browse Formulary | |||||
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Aetna Medicare Standard Plan (HMO) - H0901-004-0 Benefit Details |
District of Columbia | $34.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $7.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 176 members Browse Formulary | |||||
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Bravo Freedom (PPO) - H9184-001-0 Benefit Details |
District of Columbia | $41.00 | $0 | No Gap Coverage | Generic: $4.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Specialty: 33% | 37 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 Medicare Plus High w/o D AB (Cost) - H2150-021-0 Benefit Details |
District of Columbia | $53.60 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 703 members | ||||||
SecurityChoice Classic (PFFS) - H0540-088-0 Benefit Details |
District of Columbia | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
SecurityChoice Plus (PFFS) - H0540-089-0 Benefit Details |
District of Columbia | $56.00 | $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% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Aetna Medicare Premier Plan (HMO) - H0901-007-0 Benefit Details |
District of Columbia | $69.00 | $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% | 52 members Browse Formulary | |||||
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Bravo Premier Plus (HMO-POS) - H2108-026-0 Benefit Details |
District of Columbia | $91.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
Kaiser Permanente Medicare Plus High w/D AB (Cost) - H2150-002-0 Benefit Details |
District of Columbia | $96.00 | $0 | All Generics | Generic: $10.00 Brand: $30.00 Specialty: 10% | 15,527 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Bravo Liberty II Rx (PFFS) - H6421-012-0 Benefit Details |
District of Columbia | $115.00 | $0 | No Gap Coverage | Generic: $8.50 Preferred Brand: $45.00 Non-Preferred Brand: $80.00 Specialty: 33% | 161 members Browse Formulary | |||||
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Aetna Medicare Premier Plan (PPO) - H5521-015-0 Benefit Details |
District of Columbia | $169.00 | $100 | No Gap Coverage | Tier 1 - Preferred Generic: $11.00 Tier 2 - Non-Preferred Generic: $27.00 Tier 3 - Preferred Brand: $29.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: 25% | 71 members Browse Formulary | |||||
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