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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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Care Improvement Plus Gold Rx (Regional PPO) - R9896-009-0 Benefit Details |
Monroe | $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 | |||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Monroe | $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 | ||||||
Southeast Community Care - Plus (HMO) - H5578-012-0 Benefit Details |
Monroe | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $7.50 Tier 2 - Non-Preferred Generic: $20.00 Tier 3 - Preferred Brand: $44.00 Tier 4 - Non-Preferred Brand: $79.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 100 members Browse Formulary | |||||
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Care Improvement Plus Gold Rx Advantage (Regional PPO) - R9896-010-0 Benefit Details |
Monroe | $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 | |||||
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 |
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 | |||||
Southeast Community Care - Dual Plus (HMO) - H5578-007-0 Benefit Details |
Monroe | $ 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% | 323 members Browse Formulary | |||||
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SmartValue Classic (PFFS) - H0540-090-0 Benefit Details |
Monroe | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 11,362 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H2944-116 (PFFS) - H2944-116-0 Benefit Details |
Monroe | $26.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 354 members Browse Formulary | |||||
Evercare Plan IP (PPO) - H1108-001-0 Benefit Details |
Monroe | $29.60 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 2,170 members Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R9896-008-0 Benefit Details |
Monroe | $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 | |||||||||
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 | |||||
SmartValue Plus (PFFS) - H0540-091-0 Benefit Details |
Monroe | $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 | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-013-0 Benefit Details |
Monroe | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 337 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any MA Only (PFFS) - H5820-029-0 Benefit Details |
Monroe | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 872 members | ||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Monroe | $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 (PFFS) - H5421-056-0 Benefit Details |
Monroe | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 869 members | ||||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Monroe | $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 |
Monroe | $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 |
Monroe | $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 Plus RX Plan Two (PFFS) - H2762-030-0 Benefit Details |
Monroe | $60.00 | $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 H2944-115 (PFFS) - H2944-115-0 Benefit Details |
Monroe | $68.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 5,058 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-074-0 Benefit Details |
Monroe | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 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 | |||||||||
Any, Any, Any Platinum (PFFS) - H5820-013-0 Benefit Details |
Monroe | $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 | |||||
Today's Options Premier (PFFS) - H5421-050-0 Benefit Details |
Monroe | $89.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-017-0 Benefit Details |
Monroe | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 165 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 Four (PFFS) - H2762-038-0 Benefit Details |
Monroe | $135.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 442 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-068-0 Benefit Details |
Monroe | $138.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 607 members Browse Formulary | |||||
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