$dynamicTitle=$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 |
|||||||||
AARP MedicareComplete Plus (HMO-POS) - H2182-001-0 Benefit Details |
DeKalb | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $4.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 6,388 members Browse Formulary | |||||
new | new | new | |||||||||
Advantra Silver (HMO-POS) - H5302-003-0 Benefit Details |
DeKalb | $0.00 | $0 | Many Generics | preferred generic: $4.00 preferred brand: $37.00 non-preferred generic/Non-preferred brand: $69.00 Specialty - Generic and Brand: 33% | 2,372 members Browse Formulary | |||||
-- | |||||||||||
Aetna Medicare Value Plan (HMO) - H1109-001-0 Benefit Details |
DeKalb | $0.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $38.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 2,191 members Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
BlueValue Basic (HMO) - H5422-006-0 Benefit Details |
DeKalb | $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% | 451 members Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO) - R9896-009-0 Benefit Details |
DeKalb | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO) - R9896-009-0 Benefit Details |
Statewide | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 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 | |||||||||
CIGNA Medicare Access Plan One (PFFS) - H2762-012-0 Benefit Details |
DeKalb | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,544 members | ||||||
Humana Gold Plus H4141-001 (HMO) - H4141-001-0 Benefit Details |
DeKalb | $0.00 | $0 | Many Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 985 members Browse Formulary | |||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
DeKalb | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,697 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,697 members | ||||||
Kaiser Permanente Senior Advantage Basic (HMO) - H1170-009-0 Benefit Details |
DeKalb | $0.00 | $0 | All Generics | Generic: $10.00 Brand: $40.00 Specialty: 25% | n/a Browse Formulary | |||||
Patriot Plan (PFFS) - H9720-038-0 Benefit Details |
DeKalb | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 39 members | ||||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Patriot Plus Plan (PFFS) - H9720-039-0 Benefit Details |
DeKalb | $0.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $39.00 Tier 3: $69.00 Tier 4: 33% | 211 members Browse Formulary | |||||
-- | |||||||||||
SecureHorizons MedicareDirect Plan 2 (PFFS) - H5435-002-0 Benefit Details |
DeKalb | $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 |
DeKalb | $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 | |||||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R9896-010-0 Benefit Details |
DeKalb | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R9896-010-0 Benefit Details |
Statewide | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Evercare Plan DP (PPO) - H1108-002-0 Benefit Details |
DeKalb | $ 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% | 2,497 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 Plus RX Plan Two (PFFS) - H2762-028-0 Benefit Details |
DeKalb | $20.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 7,225 members Browse Formulary | |||||
SmartValue Classic (PFFS) - H0540-090-0 Benefit Details |
DeKalb | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 11,362 members | ||||||
Senior Advantage Medicare Medicaid Plan (HMO) - H1170-008-0 Benefit Details |
DeKalb | $ 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: $39.00 Specialty: 25% | 828 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 MP (PPO) - H1108-006-0 Benefit Details |
DeKalb | $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% | 3,938 members Browse Formulary | |||||
Evercare Plan IP (PPO) - H1108-001-0 Benefit Details |
DeKalb | $29.60 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 2,170 members Browse Formulary | |||||
Humana Gold Choice H2944-117 (PFFS) - H2944-117-0 Benefit Details |
DeKalb | $30.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 94 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 Value (PFFS) - H5421-055-0 Benefit Details |
DeKalb | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,383 members | ||||||
Care Improvement Plus Silver Rx (Regional PPO) - R9896-008-0 Benefit Details |
DeKalb | $32.50 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R9896-008-0 Benefit Details |
Statewide | $32.50 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 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 | |||||||||
Advantra Silver Plus (HMO-POS) - H5302-006-0 Benefit Details |
DeKalb | $35.00 | $0 | Many Generics | preferred generic: $4.00 preferred brand: $36.00 non-preferred generic/Non-preferred brand: $68.00 Specialty - Generic and Brand: 33% | 342 members Browse Formulary | |||||
-- | |||||||||||
HumanaChoice H5214-003 (PPO) - H5214-003-0 Benefit Details |
DeKalb | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 10,623 members Browse Formulary | |||||
SmartValue Plus (PFFS) - H0540-091-0 Benefit Details |
DeKalb | $40.00 | $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% | 12,629 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 Advantage 2 powered by CCRx (PPO) - H5378-193-0 Benefit Details |
DeKalb | $41.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 3,455 members Browse Formulary | |||||
new | new | new | |||||||||
BlueValue Secure (HMO) - H5422-002-0 Benefit Details |
DeKalb | $46.00 | $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 | |||||
Any, Any, Any MA Only (PFFS) - H5820-029-0 Benefit Details |
DeKalb | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 872 members | ||||||
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 (HMO) - H1170-002-0 Benefit Details |
DeKalb | $49.00 | $0 | All Generics | Generic: $8.00 Brand: $40.00 Specialty: 25% | 8,127 members Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
DeKalb | $50.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $37.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Statewide | $50.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $37.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-073-0 Benefit Details |
DeKalb | $51.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 10,805 members Browse Formulary | |||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
DeKalb | $57.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 148 members Browse Formulary | |||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Statewide | $57.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 148 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any Gold (PFFS) - H5820-011-0 Benefit Details |
DeKalb | $59.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 15,561 members Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
DeKalb | $59.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $84.00 Specialty: 33% | 14,668 members Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
Statewide | $59.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $84.00 Specialty: 33% | 14,668 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) - H2762-016-0 Benefit Details |
DeKalb | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 608 members | ||||||
Aetna Medicare Standard Plan (PPO) - H1110-001-0 Benefit Details |
DeKalb | $68.00 | $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: $75.00 Tier 5 - Specialty: 25% | 209 members Browse Formulary | |||||
-- | |||||||||||
Today's Options Advantage 1 powered by CCRx (PPO) - H5378-178-0 Benefit Details |
DeKalb | $69.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 622 members Browse Formulary | |||||
new | new | new | |||||||||
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) - H5421-049-0 Benefit Details |
DeKalb | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,597 members | ||||||
Humana Gold Choice H2944-118 (PFFS) - H2944-118-0 Benefit Details |
DeKalb | $71.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
Any, Any, Any Platinum (PFFS) - H5820-013-0 Benefit Details |
DeKalb | $89.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 612 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 Plus RX Plan Four (PFFS) - H2762-036-0 Benefit Details |
DeKalb | $90.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 2,420 members Browse Formulary | |||||
Aetna Medicare Premier Plan (HMO) - H1109-003-0 Benefit Details |
DeKalb | $98.00 | $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% | 663 members Browse Formulary | |||||
-- | |||||||||||
Today's Options Advantage 3 powered by CCRx (PPO) - H5378-185-0 Benefit Details |
DeKalb | $102.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 461 members Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Partners (PPO) - H9988-001-0 Benefit Details |
DeKalb | $108.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | < 10 members | ||||||
Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details |
DeKalb | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-067-0 Benefit Details |
DeKalb | $112.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,339 members 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 (PPO) - H1110-003-0 Benefit Details |
DeKalb | $123.00 | $0 | No Gap Coverage | 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: 25% | 188 members Browse Formulary | |||||
-- | |||||||||||
Sterling Partners (PPO) - H9988-002-0 Benefit Details |
DeKalb | $139.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $33.00 Specialty: 25% | < 10 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
DeKalb | $170.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option I (PFFS) - H5006-014-3 Benefit Details |
DeKalb | $183.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Sterling Option IV (PFFS) - H5006-016-3 Benefit Details |
DeKalb | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
|