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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 Choice (Regional PPO) - R7444-001-0 Benefit Details |
Hampshire | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $41.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 20,637 members Browse Formulary | |||||
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AARP MedicareComplete Choice (Regional PPO) - R7444-001-0 Benefit Details |
Statewide | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $41.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 20,637 members Browse Formulary | |||||
new | new | new | |||||||||
CIGNA Medicare Access Plan One (PFFS) - H2762-012-0 Benefit Details |
Hampshire | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,544 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Fallon Senior Plan Saver (HMO) - H9001-010-0 Benefit Details |
Hampshire | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Fresenius Medical Care Health Plan (PFFS) - H5909-001-0 Benefit Details |
Hampshire | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 78 members | ||||||
HNE Medicare Basic No Rx (HMO) - H8578-009-0 Benefit Details |
Hampshire | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 48 members | ||||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Hampshire | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-028-0 Benefit Details |
Hampshire | $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 | |||||
Tufts Medicare Preferred HMO Basic (HMO) - H2256-025-0 Benefit Details |
Hampshire | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 584 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Hampshire | $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 | |||||
Fallon Senior Plan Saver Basic Rx (HMO) - H9001-011-0 Benefit Details |
Hampshire | $33.00 | $310 | No Gap Coverage | Tier 1: $5.00 Tier 2: $20.00 Tier 3: $40.00 Tier 4: 25% | 2,828 members Browse Formulary | |||||
Fallon Senior Plan Saver Enhanced Rx (HMO) - H9001-013-0 Benefit Details |
Hampshire | $33.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $65.00 | 5,000 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HNE Medicare Plus No Rx (HMO) - H8578-006-0 Benefit Details |
Hampshire | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 19 members | ||||||
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HNE Medicare Basic Rx (HMO) - H8578-008-0 Benefit Details |
Hampshire | $40.00 | $0 | No Gap Coverage | Generic: $10.00 Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 246 members Browse Formulary | |||||
new | new | new | |||||||||
Today's Options Value (PFFS) - H3333-122-0 Benefit Details |
Hampshire | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 59 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Tufts Medicare Preferred HMO Basic Rx (HMO) - H2256-024-0 Benefit Details |
Hampshire | $53.70 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $42.00 Tier 3: $83.00 | 2,683 members Browse Formulary | |||||
HNE Medicare Basic Rx Enhanced (HMO) - H8578-007-0 Benefit Details |
Hampshire | $58.00 | $0 | All Generics | Generic: $10.00 Brand: $25.00 Non-Preferred Brand: $45.00 Specialty: 25% | 89 members Browse Formulary | |||||
new | new | new | |||||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-016-0 Benefit Details |
Hampshire | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 608 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Tufts Medicare Preferred HMO Value (HMO) - H2256-019-7 Benefit Details |
Hampshire | $62.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 565 members | ||||||
HNE Medicare Premium No Rx (HMO) - H8578-003-0 Benefit Details |
Hampshire | $66.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 80 members | ||||||
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Today's Options Value powered by CCRx (PFFS) - H3333-123-0 Benefit Details |
Hampshire | $66.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 112 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
First Seniority Freedom - No Drug (PFFS) - H7226-015-0 Benefit Details |
Hampshire | $68.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 242 members | ||||||
Tufts Medicare Preferred HMO Basic Rx Plus (HMO) - H2256-023-0 Benefit Details |
Hampshire | $72.80 | $0 | All Generics | Tier 1: $10.00 Tier 2: $30.00 Tier 3: $70.00 | 539 members Browse Formulary | |||||
HNE Medicare Plus Rx (HMO) - H8578-005-0 Benefit Details |
Hampshire | $75.00 | $0 | No Gap Coverage | Generic: $10.00 Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 230 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 | |||||||||
Fallon Senior Plan Standard (HMO) - H9001-001-0 Benefit Details |
Hampshire | $82.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Today's Options Premier (PFFS) - H3333-120-0 Benefit Details |
Hampshire | $84.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 185 members | ||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-036-0 Benefit Details |
Hampshire | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Tufts Medicare Preferred HMO Prime (HMO) - H2256-016-2 Benefit Details |
Hampshire | $92.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,770 members | ||||||
HNE Medicare Plus Rx Enhanced (HMO) - H8578-004-0 Benefit Details |
Hampshire | $93.00 | $0 | All Generics | Generic: $10.00 Brand: $25.00 Non-Preferred Brand: $45.00 Specialty: 25% | 155 members Browse Formulary | |||||
new | new | new | |||||||||
Tufts Medicare Preferred HMO Value Rx (HMO) - H2256-018-7 Benefit Details |
Hampshire | $95.70 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $42.00 Tier 3: $83.00 | 4,210 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
First Seniority Freedom - Drug (PFFS) - H7226-013-0 Benefit Details |
Hampshire | $103.90 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $35.00 Tier 3: $70.00 | 294 members Browse Formulary | |||||
HNE Medicare Premium Rx (HMO) - H8578-002-0 Benefit Details |
Hampshire | $105.00 | $0 | No Gap Coverage | Generic: $10.00 Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 652 members Browse Formulary | |||||
new | new | new | |||||||||
Fallon Senior Plan Standard Basic Rx (HMO) - H9001-014-0 Benefit Details |
Hampshire | $112.00 | $310 | No Gap Coverage | Tier 1: $5.00 Tier 2: $20.00 Tier 3: $40.00 Tier 4: 25% | 2,790 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Fallon Senior Plan Standard Enhanced Rx (HMO) - H9001-015-0 Benefit Details |
Hampshire | $112.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $65.00 | 3,311 members Browse Formulary | |||||
Tufts Medicare Preferred HMO Value Rx Plus (HMO) - H2256-017-7 Benefit Details |
Hampshire | $114.80 | $0 | All Generics | Tier 1: $10.00 Tier 2: $30.00 Tier 3: $70.00 | n/a Browse Formulary | |||||
HNE Medicare Premium Rx Enhanced (HMO) - H8578-001-0 Benefit Details |
Hampshire | $123.00 | $0 | All Generics | Generic: $10.00 Brand: $25.00 Non-Preferred Brand: $45.00 Specialty: 25% | n/a 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 | |||||||||
Medicare PPO Blue PlusRx (PPO) - H2230-002-0 Benefit Details |
Hampshire | $123.10 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $35.00 Tier 3: $65.00 Tier 4: 25% | 11,412 members Browse Formulary | |||||
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Tufts Medicare Preferred HMO Prime Rx (HMO) - H2256-015-2 Benefit Details |
Hampshire | $125.70 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $42.00 Tier 3: $83.00 | 15,944 members Browse Formulary | |||||
First Seniority Freedom Plus - Drug (PFFS) - H7226-011-0 Benefit Details |
Hampshire | $127.00 | $0 | All Generics | Tier 1: $10.00 Tier 2: $30.00 Tier 3: $60.00 | 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 Premier powered by CCRx (PFFS) - H3333-121-0 Benefit Details |
Hampshire | $129.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 50 members Browse Formulary | |||||
Fallon Senior Plan Preferred Enhanced Rx (PPO) - H2411-002-0 Benefit Details |
Hampshire | $141.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $65.00 | 357 members Browse Formulary | |||||
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Tufts Medicare Preferred HMO Prime Rx Plus (HMO) - H2256-001-2 Benefit Details |
Hampshire | $144.80 | $0 | All Generics | Tier 1: $10.00 Tier 2: $30.00 Tier 3: $70.00 | 35,528 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HNE Medicare Freedom (HMO-POS) - H8578-010-0 Benefit Details |
Hampshire | $151.00 | $0 | All Generics | Generic: $10.00 Brand: $25.00 Non-Preferred Brand: $45.00 Specialty: 25% | 112 members Browse Formulary | |||||
new | new | new | |||||||||
Humana Gold Choice H2944-072 (PFFS) - H2944-072-0 Benefit Details |
Hampshire | $164.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 705 members Browse Formulary | |||||
Medicare HMO Blue PlusRx (HMO) - H2261-005-0 Benefit Details |
Hampshire | $179.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 12,864 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Fallon Senior Plan Plus Enhanced Rx (HMO) - H9001-017-0 Benefit Details |
Hampshire | $181.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $65.00 | 5,499 members Browse Formulary | |||||
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