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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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AARP MedicareComplete Plus (HMO-POS) - H3456-001-0 Benefit Details |
Person | $0.00 | $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% | 34,586 members Browse Formulary | |||||
AARP MedicareComplete Plus Essential (HMO-POS) - H3456-020-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Advantra Gold (PPO) - H9847-001-0 Benefit Details |
Person | $0.00 | $0 | No Gap Coverage | Preferred Generic: $7.00 Preferred Brand: $33.00 Non-Preferred Generic/Non-Preferred Brand: $63.00 Specialty - Generic and Brand: 33% | 4,780 members Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare HMO Medical Only (HMO) - H3449-012-0 Benefit Details |
Person | $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 |
Person | $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 | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-020-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 13,290 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) - H2762-042-0 Benefit Details |
Person | $0.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 40,257 members Browse Formulary | |||||
Evercare Plan MH (HMO) - H3456-022-0 Benefit Details |
Person | $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% | 16,341 members Browse Formulary | |||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Person | $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 | ||||||
Patriot (PFFS) - H0979-004-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 755 members | ||||||
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Patriot Plus (PFFS) - H0979-005-0 Benefit Details |
Person | $0.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $45.00 Tier 3: $75.00 Tier 4: 33% | 4,137 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 | |||||||||
Presidential (PFFS) - H0979-006-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 294 members | ||||||
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SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Today's Options Premier (PFFS) - H5421-046-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,278 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) - H5421-052-0 Benefit Details |
Person | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 740 members | ||||||
Humana Gold Choice H2944-134 (PFFS) - H2944-134-0 Benefit Details |
Person | $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% | 491 members Browse Formulary | |||||
Presidential Plus (PFFS) - H0979-007-0 Benefit Details |
Person | $21.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $39.00 Tier 3: $69.00 Tier 4: 33% | n/a 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-070-0 Benefit Details |
Person | $21.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 3,334 members Browse Formulary | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Person | $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 | |||||
Evercare Plan DH (HMO) - H3456-016-0 Benefit Details |
Person | $ 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% | 7,635 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 |
Person | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Humana Gold Choice H2944-133 (PFFS) - H2944-133-0 Benefit Details |
Person | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 23,180 members Browse Formulary | |||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-024-0 Benefit Details |
Person | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,787 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Person | $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 | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-064-0 Benefit Details |
Person | $58.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,188 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 I (PFFS) - H5006-014-1 Benefit Details |
Person | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Person | $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 | |||||||||
Advantra Platinum (PPO) - H9847-003-0 Benefit Details |
Person | $75.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $68.00 Specialty - Generic and Brand: 33% | 64 members Browse Formulary | |||||
new | new | new | |||||||||
Blue Medicare HMO Enhanced (HMO) - H3449-005-0 Benefit Details |
Person | $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 | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-050-0 Benefit Details |
Person | $85.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 9,959 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare PPO Enhanced (PPO) - H3404-001-0 Benefit Details |
Person | $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 | |||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
Person | $99.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Sterling Option IV (PFFS) - H5006-016-1 Benefit Details |
Person | $119.00 | $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 | |||||||||
Blue Medicare PPO Enhanced Freedom (PPO) - H3404-002-0 Benefit Details |
Person | $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 | |||||
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