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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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AARP MedicareComplete Plus Plan 1 (HMO-POS) - H2803-001-0 Benefit Details |
Pottawattamie | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 4,254 members Browse Formulary | |||||
AARP MedicareComplete Plus Plan 2 (HMO-POS) - H2802-001-0 Benefit Details |
Pottawattamie | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 4,405 members Browse Formulary | |||||
Advantra Platinum PPO SW (PPO) - H1608-003-0 Benefit Details |
Pottawattamie | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | 247 members Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Advantra Silver SW (HMO) - H1609-007-0 Benefit Details |
Pottawattamie | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty - Generic and Brand: 33% | 276 members Browse Formulary | |||||
HumanaChoice H6609-004 (PPO) - H6609-004-0 Benefit Details |
Pottawattamie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 56 members | ||||||
SecureHorizons MedicareDirect Plan 2 (PFFS) - H5435-002-0 Benefit Details |
Pottawattamie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 16,559 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Rx Plan 55 (PFFS) - H5435-024-0 Benefit Details |
Pottawattamie | $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 | |||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Pottawattamie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Pottawattamie | $23.00 | $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% | 15,526 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Plan 100 (PFFS) - H5435-020-0 Benefit Details |
Pottawattamie | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,121 members | ||||||
Today's Options Value (PFFS) - H5421-055-0 Benefit Details |
Pottawattamie | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,383 members | ||||||
SecureHorizons MedicareDirect Rx Plan 150 (PFFS) - H5435-027-0 Benefit Details |
Pottawattamie | $35.00 | $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% | 4,555 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 |
Pottawattamie | $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 | |||||||||
Humana Gold Choice H2944-004 (PFFS) - H2944-004-0 Benefit Details |
Pottawattamie | $48.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 9,161 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-073-0 Benefit Details |
Pottawattamie | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Pottawattamie | $57.30 | $310 | No Gap Coverage | Level 1: Covered Generic: 13% Level 2: Covered Preferred Brand: 23% Level 3: Covered Brand: 50% Covered Specialty: 25% | 22,330 members Browse Formulary | |||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Statewide | $57.30 | $310 | No Gap Coverage | Level 1: Covered Generic: 13% Level 2: Covered Preferred Brand: 23% Level 3: Covered Brand: 50% Covered Specialty: 25% | 22,330 members Browse Formulary | |||||
Sterling Basic Plus (PFFS) - H5006-018-2 Benefit Details |
Pottawattamie | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H2944-005 (PFFS) - H2944-005-0 Benefit Details |
Pottawattamie | $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% | 3,034 members Browse Formulary | |||||
HumanaChoice H6609-003 (PPO) - H6609-003-0 Benefit Details |
Pottawattamie | $69.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 341 members Browse Formulary | |||||
Today's Options Advantage 1 powered by CCRx (PPO) - H5378-178-0 Benefit Details |
Pottawattamie | $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 |
Pottawattamie | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,597 members | ||||||
Sterling Option I (PFFS) - H5006-014-2 Benefit Details |
Pottawattamie | $94.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Today's Options Advantage 3 powered by CCRx (PPO) - H5378-185-0 Benefit Details |
Pottawattamie | $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 Option II (PFFS) - H5006-017-2 Benefit Details |
Pottawattamie | $107.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-067-0 Benefit Details |
Pottawattamie | $112.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,339 members Browse Formulary | |||||
Sterling Option IV (PFFS) - H5006-016-2 Benefit Details |
Pottawattamie | $120.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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