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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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BCN Advantage (HMO) - H5883-001-1 Benefit Details |
Ottawa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Ottawa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,098 members | ||||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,098 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
PriorityMedicare Value (HMO-POS) - H2320-015-0 Benefit Details |
Ottawa | $0.00 | $0 | No Gap Coverage | Generic: $8.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | 5,240 members Browse Formulary | |||||
SecureHorizons MedicareComplete Plus (HMO-POS) - H4971-001-0 Benefit Details |
Ottawa | $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: $79.00 Tier 4 Specialty: 33% | n/a Browse Formulary | |||||
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SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Ottawa | $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 | |||||||||
Today's Options Value (PFFS) - H5421-053-0 Benefit Details |
Ottawa | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 7,273 members | ||||||
Today's Options Value powered by CCRx (PFFS) - H5421-071-0 Benefit Details |
Ottawa | $21.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 9,163 members Browse Formulary | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Ottawa | $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 | |||||||||
PriorityMedicare (HMO-POS) - H2320-013-0 Benefit Details |
Ottawa | $33.40 | $0 | No Gap Coverage | Generic: $8.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | 12,600 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-047-0 Benefit Details |
Ottawa | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,082 members | ||||||
Sterling Basic Plus (PFFS) - H5006-018-2 Benefit Details |
Ottawa | $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 | |||||||||
Medicare Plus Blue PPO (PPO) - H9572-001-1 Benefit Details |
Ottawa | $61.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $30.00 Non Preferred: $95.00 Specialty: 25% Non Self Administered Injectable: 25% | 14,447 members Browse Formulary | |||||
PriorityMedicare Plus (HMO-POS) - H2320-014-0 Benefit Details |
Ottawa | $61.50 | $0 | Many Generics | Generic: $8.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | 3,546 members Browse Formulary | |||||
Humana Gold Choice H2944-051 (PFFS) - H2944-051-0 Benefit Details |
Ottawa | $64.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 769 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
BCN Advantage (HMO) - H5883-002-1 Benefit Details |
Ottawa | $73.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Preferred Brand: $35.00 Non Preferred: $75.00 Specialty: 25% Injectable: 25% | 12,180 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-065-0 Benefit Details |
Ottawa | $77.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,790 members Browse Formulary | |||||
PriorityMedicare Choice (PPO) - H4875-001-0 Benefit Details |
Ottawa | $77.80 | $0 | No Gap Coverage | Generic: $8.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | 4,999 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Plus Blue Option A (PFFS) - H2319-008-9 Benefit Details |
Ottawa | $81.00 | $0 | No Gap Coverage | Generic: $9.00 Preferred Brand: $35.00 Non Preferred: $90.00 Specialty: 25% Non Self Administered Injectable: 25% | 20,858 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-2 Benefit Details |
Ottawa | $94.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Ottawa | $96.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Statewide | $96.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Ottawa | $107.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 9,118 members Browse Formulary | |||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Statewide | $107.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 9,118 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 II (PFFS) - H5006-017-2 Benefit Details |
Ottawa | $107.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Medicare Plus Blue Option B (PFFS) - H2319-009-1 Benefit Details |
Ottawa | $116.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $30.00 Non Preferred: $70.00 Specialty: 25% Non Self Administered Injectable: 25% | 26,161 members Browse Formulary | |||||
Sterling Option IV (PFFS) - H5006-016-2 Benefit Details |
Ottawa | $120.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
BCN Advantage (HMO) - H5883-003-1 Benefit Details |
Ottawa | $151.00 | $0 | Many Generics | Preferred Generic: $3.00 Preferred Brand: $30.00 Non-Preferred: $65.00 Specialty: 25% Injectable: 25% | 6,211 members Browse Formulary | |||||
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