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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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Blue Medicare HMO Medical Only (HMO) - H3449-012-0 Benefit Details |
Chowan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,286 members | ||||||
Blue Medicare HMO Standard (HMO) - H3449-013-0 Benefit Details |
Chowan | $0.00 | $0 | No Gap Coverage | Tier 1 - Generics: $7.00 Tier 2 - Preferred brand: $40.00 Tier 3 - Non-preferred brand: $80.00 Tier 4 - Specialty: 33% | 5,342 members Browse Formulary | |||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Chowan | $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 | |||||||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Presidential Plan (PFFS) - H0979-021-0 Benefit Details |
Chowan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 496 members | ||||||
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SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Chowan | $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) - H5421-149-0 Benefit Details |
Chowan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,299 members | ||||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Chowan | $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 | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-150-0 Benefit Details |
Chowan | $23.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,210 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 H2944-136 (PFFS) - H2944-136-0 Benefit Details |
Chowan | $30.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 241 members Browse Formulary | |||||
Presidential Plus Plan (PFFS) - H0979-022-0 Benefit Details |
Chowan | $45.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $45.00 Tier 3: $75.00 Tier 4: 33% | 654 members Browse Formulary | |||||
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CIGNA Medicare Access Plan One (PFFS) - H2762-022-0 Benefit Details |
Chowan | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 249 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H2944-135 (PFFS) - H2944-135-0 Benefit Details |
Chowan | $55.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 8,054 members Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Chowan | $56.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 727 members Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Statewide | $56.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 727 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 Two (PFFS) - H2762-046-0 Benefit Details |
Chowan | $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 | |||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Chowan | $72.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $85.00 Specialty: 33% | 3,887 members Browse Formulary | |||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Statewide | $72.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $85.00 Specialty: 33% | 3,887 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) - H5421-147-0 Benefit Details |
Chowan | $74.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Blue Medicare HMO Enhanced (HMO) - H3449-005-0 Benefit Details |
Chowan | $80.90 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 22,396 members Browse Formulary | |||||
Blue Medicare PPO Enhanced (PPO) - H3404-001-0 Benefit Details |
Chowan | $97.60 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 2,643 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 Plan Three (PFFS) - H2762-026-0 Benefit Details |
Chowan | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 42 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-148-0 Benefit Details |
Chowan | $120.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 643 members Browse Formulary | |||||
Blue Medicare PPO Enhanced Freedom (PPO) - H3404-002-0 Benefit Details |
Chowan | $147.50 | $0 | Many Generics | Tier 1 - Generic: $6.00 Tier 2 - Preferred Brand: $35.00 Tier 3 - Non-preferred: $75.00 Tier 4 - Specialty: 33% | 3,311 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) - H2762-054-0 Benefit Details |
Chowan | $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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