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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. |
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AARP MedicareComplete (HMO) - H2654-004-0 Benefit Details |
St. Louis City | $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% | 17,345 members Browse Formulary | |||||
AARP MedicareComplete Essential (HMO) - H2654-020-0 Benefit Details |
St. Louis City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 175 members | ||||||
AARP MedicareComplete Plus Essential (HMO-POS) - H2654-022-0 Benefit Details |
St. Louis City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 192 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
AARP MedicareComplete Plus Plan 1 (HMO-POS) - H2654-013-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $6.00 Tier 2 Generic Preferred Brand: $40.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $75.00 Tier 4 Specialty: 33% | 8,486 members Browse Formulary | |||||
Advantra Option 1 (HMO) - H2663-006-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Preferred Brand: $34.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | 6,612 members Browse Formulary | |||||
Advantra Option 4 (HMO) - H2663-013-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $34.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | 738 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 |
St. Louis City | $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 | |||||
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 | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-012-0 Benefit Details |
St. Louis City | $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 | |||||||||
Essence Advantage (HMO) - H2610-005-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Tier 1 Generic: $5.00 Tier 2 Preferred Brand: $29.00 Tier 3 Non-preferred Brand: $59.00 Tier 4 Specialty: 20% | 20,515 members Browse Formulary | |||||
Essence Advantage Special Needs Plan (HMO) - H2610-010-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Tier 1 Generic: $5.00 Tier 2 Preferred Brand: $29.00 Tier 3 Non-preferred Brand: $59.00 Tier 4 Specialty: 20% | 2,728 members Browse Formulary | |||||
Evercare Plan MH (HMO) - H2654-026-0 Benefit Details |
St. Louis City | $0.00 | $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% | 3,258 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Gold Advantage Option 1 (HMO) - H2663-005-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Preferred Brand: $34.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | 5,508 members Browse Formulary | |||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
St. Louis City | $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 (PPO) - H2611-001-0 Benefit Details |
St. Louis City | $0.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 25% | 5,665 members Browse Formulary | |||||
Mercy MedicareADVANTAGE (HMO) - H2667-003-0 Benefit Details |
St. Louis City | $13.00 | $0 | No Gap Coverage | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 25% | 3,129 members Browse Formulary | |||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R3444-010-0 Benefit Details |
St. Louis City | $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 |
St. Louis City | $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 |
St. Louis City | $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 | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Evercare Plan DH (HMO) - H2654-024-0 Benefit Details |
St. Louis City | $ 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% | n/a Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-028-0 Benefit Details |
St. Louis City | $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 | |||||
Humana Gold Choice H2944-014 (PFFS) - H2944-014-0 Benefit Details |
St. Louis City | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Advantra Option 3 (HMO) - H2663-012-0 Benefit Details |
St. Louis City | $32.70 | $0 | No Gap Coverage | Preferred Generic: $7.00 Preferred Brand: $28.00 Non-Preferred Generic/Non-Preferred Brand: $60.00 Specialty: 33% | 569 members Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R3444-008-0 Benefit Details |
St. Louis City | $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 | |||||
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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
AARP MedicareComplete Choice (PPO) - H5507-001-0 Benefit Details |
St. Louis City | $35.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $42.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $79.00 Tier 4 Specialty: 33% | 4,288 members Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
St. Louis City | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Basic Plus (PFFS) - H5006-018-1 Benefit Details |
St. Louis City | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
SmartValue Plus (PFFS) - H2613-004-0 Benefit Details |
St. Louis City | $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 | |||||
Anthem Medicare Preferred Select (PPO) - H1517-003-0 Benefit Details |
St. Louis City | $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 | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Essence Advantage Plus (HMO) - H2610-006-0 Benefit Details |
St. Louis City | $56.00 | $0 | Many Generics | Tier 1 Generic: $2.00 Tier 2 Preferred Brand: $20.00 Tier 3 Non-preferred Brand: $50.00 Tier 4 Specialty: 20% | 964 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
St. Louis City | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-016-0 Benefit Details |
St. Louis City | $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 | |||||||||
Today's Options Value (PFFS) - H5421-165-0 Benefit Details |
St. Louis City | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
Advantra Option 2 (HMO) - H2663-002-0 Benefit Details |
St. Louis City | $69.00 | $0 | No Gap Coverage | Preferred Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty: 33% | 7,000 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
St. Louis City | $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 Plus RX Plan Four (PFFS) - H2762-036-0 Benefit Details |
St. Louis City | $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 | |||||
HumanaChoice H1716-006 (PPO) - H1716-006-0 Benefit Details |
St. Louis City | $99.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 730 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
St. Louis City | $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 |
St. Louis City | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
St. Louis City | $113.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 797 members Browse Formulary | |||||
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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option IV (PFFS) - H5006-016-1 Benefit Details |
St. Louis City | $119.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
Mercy MedicareADVANTAGE Plan 2 (PPO) - H2611-012-0 Benefit Details |
St. Louis City | $130.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 25% | 289 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
St. Louis City | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
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