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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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Martin's Point Generations Advantage Value (HMO) - H5591-003-0 Benefit Details |
Piscataquis | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 459 members | ||||||
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Northeast Community Care - Plus (HMO) - H5619-004-0 Benefit Details |
Piscataquis | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $7.50 Tier 2 - Non-Preferred Generic: $15.00 Tier 3 - Preferred Brand: $44.00 Tier 4 - Non-Preferred Brand: $79.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 564 members Browse Formulary | |||||
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SecureHorizons MedicareDirect Plan 1 (PFFS) - H5435-001-0 Benefit Details |
Piscataquis | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 27,113 members | ||||||
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) - H3333-039-0 Benefit Details |
Piscataquis | $10.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 956 members | ||||||
SmartValue Classic (PFFS) - H1689-012-0 Benefit Details |
Piscataquis | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,461 members | ||||||
SecureHorizons MedicareDirect Rx Plan 51 (PFFS) - H5435-014-0 Benefit Details |
Piscataquis | $20.00 | $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% | 61,945 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Northeast Community Care - Enhanced (HMO) - H5619-010-0 Benefit Details |
Piscataquis | $27.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | < 10 members Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) - H3333-057-0 Benefit Details |
Piscataquis | $29.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 843 members Browse Formulary | |||||
SmartValue Plus (PFFS) - H1689-013-0 Benefit Details |
Piscataquis | $34.50 | $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% | 8,845 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Martin's Point Generations Advantage Select (PPO) - H1365-001-0 Benefit Details |
Piscataquis | $35.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $55.00 Tier 4: 25% | 313 members Browse Formulary | |||||
Martin's Point Generations Advantage Prime (HMO-POS) - H5591-001-0 Benefit Details |
Piscataquis | $49.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $55.00 Tier 4: 25% | 4,821 members Browse Formulary | |||||
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Today's Options Premier (PFFS) - H3333-033-0 Benefit Details |
Piscataquis | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,587 members | ||||||
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) - H2762-022-0 Benefit Details |
Piscataquis | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 249 members | ||||||
First Seniority Freedom - No Drug (PFFS) - H7226-015-0 Benefit Details |
Piscataquis | $68.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 242 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-046-0 Benefit Details |
Piscataquis | $70.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 823 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) - H3333-051-0 Benefit Details |
Piscataquis | $92.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 598 members Browse Formulary | |||||
First Seniority Freedom - Drug (PFFS) - H7226-013-0 Benefit Details |
Piscataquis | $103.90 | $0 | No Gap Coverage | Tier 1: $10.00 Tier 2: $35.00 Tier 3: $70.00 | 294 members Browse Formulary | |||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-026-0 Benefit Details |
Piscataquis | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 42 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
First Seniority Freedom Plus - Drug (PFFS) - H7226-011-0 Benefit Details |
Piscataquis | $127.00 | $0 | All Generics | Tier 1: $10.00 Tier 2: $30.00 Tier 3: $60.00 | n/a Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-054-0 Benefit Details |
Piscataquis | $155.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 99 members Browse Formulary | |||||
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