$dynamicTitle=$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 |
|||||||||
AARP MedicareComplete Plus (HMO-POS) - H2654-010-0 Benefit Details |
Douglas | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $38.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $72.00 Tier 4 Specialty: 33% | 6,398 members Browse Formulary | |||||
Advantra Freedom (PPO) - H5509-011-0 Benefit Details |
Douglas | $0.00 | $0 | No Gap Coverage | PREFERRED GENERIC: $7.00 PREFERRED BRAND: $35.00 NON-PREFERRED GENERIC/NON-PREFERRED BRAND: $60.00 SPECIALTY- GENERIC AND BRAND: 33% | 2,727 members Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO) - R3444-009-0 Benefit Details |
Douglas | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,700 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Gold Rx (Regional PPO) - R3444-009-0 Benefit Details |
Statewide | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,700 members Browse Formulary | |||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Douglas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Mercy MedicareADVANTAGE (no drug) (HMO) - H2667-012-0 Benefit Details |
Douglas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 784 members | ||||||
Mercy MedicareAdvantage Silver (PPO) - H2611-018-0 Benefit Details |
Douglas | $0.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 3: $70.00 4: 25% | 4,182 members Browse Formulary | |||||
Ozark Health Plan - Plus (HMO) - H5416-018-0 Benefit Details |
Douglas | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 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 | |||||||||
SecureHorizons MedicareDirect Plan 1 (PFFS) - H5435-001-0 Benefit Details |
Douglas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 27,113 members | ||||||
Today's Options Value (PFFS) - H5421-053-0 Benefit Details |
Douglas | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 7,273 members | ||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R3444-010-0 Benefit Details |
Douglas | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R3444-010-0 Benefit Details |
Statewide | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
SmartValue Classic (PFFS) - H2613-001-0 Benefit Details |
Douglas | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 726 members | ||||||
Anthem Medicare Preferred Standard (PPO) - H1517-001-0 Benefit Details |
Douglas | $18.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 771 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 H2944-014 (PFFS) - H2944-014-0 Benefit Details |
Douglas | $20.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 10,810 members Browse Formulary | |||||
SecureHorizons MedicareDirect Rx Plan 51 (PFFS) - H5435-014-0 Benefit Details |
Douglas | $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 | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-071-0 Benefit Details |
Douglas | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Mercy MedicareADVANTAGE (HMO) - H2667-001-0 Benefit Details |
Douglas | $22.00 | $0 | No Gap Coverage | Tier 1: 25% Tier 2: 25% | 8,037 members Browse Formulary | |||||
Evercare Plan MH (HMO) - H2654-027-0 Benefit Details |
Douglas | $25.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | 233 members Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R3444-008-0 Benefit Details |
Douglas | $33.20 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,445 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Silver Rx (Regional PPO) - R3444-008-0 Benefit Details |
Statewide | $33.20 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,445 members Browse Formulary | |||||
Ozark Health Plan - Enhanced (HMO) - H5416-025-0 Benefit Details |
Douglas | $34.30 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | < 10 members Browse Formulary | |||||
Ozark Health Plan - Plus Point (HMO-POS) - H5416-029-0 Benefit Details |
Douglas | $35.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $39.00 Tier 4 - Non-Preferred Brand: $69.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 73 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Douglas | $37.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $36.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 774 members Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Statewide | $37.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $36.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 774 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-047-0 Benefit Details |
Douglas | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,082 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SmartValue Plus (PFFS) - H2613-004-0 Benefit Details |
Douglas | $42.50 | $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% | n/a Browse Formulary | |||||
HumanaChoice H1716-004 (PPO) - H1716-004-0 Benefit Details |
Douglas | $47.00 | $0 | Few Generics, Few Brand | Preferred Generic: $6.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
Anthem Medicare Preferred Select (PPO) - H1517-003-0 Benefit Details |
Douglas | $52.00 | $0 | Many Generics | Tier 1 Preferred Generic Drugs: $7.00 Tier 2 Preferred Brand Certain Generic Drugs: $43.00 Tier 3 Non-Preferred Brand Certain Generic Drugs: $85.00 Tier 4 Non-Specialty Injectable Drugs: 33% Tier 5 Specialty Drugs: 33% | 406 members Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Mercy MedicareADVANTAGE Gold (no drug) (PPO) - H2611-005-0 Benefit Details |
Douglas | $61.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 283 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-065-0 Benefit Details |
Douglas | $77.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,790 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-015-0 Benefit Details |
Douglas | $80.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 150 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-034-0 Benefit Details |
Douglas | $95.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 627 members Browse Formulary | |||||
Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details |
Douglas | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Douglas | $113.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 797 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Statewide | $113.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 797 members Browse Formulary | |||||
Mercy MedicareADVANTAGE Gold (PPO) - H2611-002-0 Benefit Details |
Douglas | $129.00 | $0 | Many Generics | Tier 1: $7.00 Tier 2: $35.00 3: $70.00 4: 25% | 2,091 members Browse Formulary | |||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-019-0 Benefit Details |
Douglas | $135.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option II (PFFS) - H5006-017-3 Benefit Details |
Douglas | $170.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-3 Benefit Details |
Douglas | $183.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Sterling Option IV (PFFS) - H5006-016-3 Benefit Details |
Douglas | $196.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
|