$dynamicTitle=$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 |
|||||||||
AAA0 Vantage ZERO (HMO-POS) - H5576-007-0 Benefit Details |
Caldwell | $0.00 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | 853 members Browse Formulary | |||||
-- | |||||||||||
Arcadian Community Care - Basic (HMO) - H7179-006-0 Benefit Details |
Caldwell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 53 members | ||||||
-- | |||||||||||
Arcadian Community Care - Plus (HMO) - H7179-002-0 Benefit Details |
Caldwell | $0.00 | $0 | Many Generics | Tier 1 - Preferred Generic: $0.00 Tier 2 - Non-Preferred Generic: $5.00 Tier 3 - Preferred Brand: $35.00 Tier 4 - Non-Preferred Brand: $65.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | n/a Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H1906-009 (PFFS) - H1906-009-0 Benefit Details |
Caldwell | $0.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 447 members Browse Formulary | |||||
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
Caldwell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,054 members | ||||||
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,054 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Plan 2 (PFFS) - H5435-002-0 Benefit Details |
Caldwell | $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 |
Caldwell | $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 |
Caldwell | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 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) - H5820-026-0 Benefit Details |
Caldwell | $9.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 92 members | ||||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Caldwell | $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 | |||||
Any, Any, Any Gold (PFFS) - H5820-002-0 Benefit Details |
Caldwell | $29.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 985 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H7002-002 (PPO) - H7002-002-0 Benefit Details |
Caldwell | $30.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
new | new | new | |||||||||
AAA4 Vantage TRADITIONAL PLUS (HMO-POS) - H5576-008-0 Benefit Details |
Caldwell | $31.30 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 151 members Browse Formulary | |||||
-- | |||||||||||
Arcadian Community Care - Dual Plus (HMO) - H7179-003-0 Benefit Details |
Caldwell | $ 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% | 894 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 One (PFFS) - H2762-021-0 Benefit Details |
Caldwell | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 550 members | ||||||
HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
Caldwell | $38.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 612 members Browse Formulary | |||||
HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
Statewide | $38.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 612 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Arcadian Community Care - Plus Point (HMO-POS) - H7179-009-0 Benefit Details |
Caldwell | $39.00 | $0 | Many Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $44.00 Tier 4 - Non-Preferred Brand: $79.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 17 members Browse Formulary | |||||
-- | |||||||||||
Sterling Basic Plus (PFFS) - H5006-018-1 Benefit Details |
Caldwell | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-044-0 Benefit Details |
Caldwell | $40.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 3,276 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H1906-001 (PFFS) - H1906-001-0 Benefit Details |
Caldwell | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $5.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 4,702 members Browse Formulary | |||||
AAA1 Vantage VALUE (HMO-POS) - H5576-009-0 Benefit Details |
Caldwell | $47.00 | $0 | No Gap Coverage | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | 43 members Browse Formulary | |||||
-- | |||||||||||
Any, Any, Any Platinum (PFFS) - H5820-008-0 Benefit Details |
Caldwell | $59.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 75 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) - H5006-014-1 Benefit Details |
Caldwell | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
Caldwell | $62.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 6,007 members Browse Formulary | |||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
Statewide | $62.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 6,007 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) - H5421-165-0 Benefit Details |
Caldwell | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
AAA2 Vantage BASIC (HMO-POS) - H5576-005-0 Benefit Details |
Caldwell | $67.00 | $0 | No Gap Coverage | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | 165 members Browse Formulary | |||||
-- | |||||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Caldwell | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 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) - H2762-025-0 Benefit Details |
Caldwell | $85.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 236 members | ||||||
AAA3 Vantage PREMIUM (HMO-POS) - H5576-006-0 Benefit Details |
Caldwell | $99.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | n/a Browse Formulary | |||||
-- | |||||||||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
Caldwell | $99.00 | $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 | |||||||||
Today's Options Premier (PFFS) - H5421-163-0 Benefit Details |
Caldwell | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
Sterling Option IV (PFFS) - H5006-016-1 Benefit Details |
Caldwell | $119.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-052-0 Benefit Details |
Caldwell | $130.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 480 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 Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Caldwell | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
|