2010 Otsego County, NY Medicare Advantage Plans

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2010 Medicare Advantage Plans: SNPs,
Health (MAs), Health & Rx Drug (MA-PDs)

This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

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Selected County:* Otsego, New York

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2:
ex: AARP

Other Options: Only plans with MOOP ≤ $3,400 Limit search to 10 plans

Maximum Premium:
$ max: $428

Maximum Deductible:
$ max: $310

Health Coverage Type:

Special Needs Plans (SNP) Options: Only show SNPs (All 3 Types)
OR only: Dual-Eligible
Chronic Condition
Institutional

Max. Copay Tier 1 (Generics):
$
tip: enter 0 to show plans with a $0 Tier 1 copay

Prescription Drug Coverage:

Additional Info:

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Link to This Chart

**There are 35 New York 2010 Medicare Advantage plans (MAPD) meeting your criteria.**

**Caution:** The **2010** Medicare Advantage plan information below is for research purposes.
**Click here to see 2024 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	County	Monthly Prem. (Parts C & D)	Deduct- ible	(Donut Hole) Gap Coverage	Preferred Pharmacy Copay/ Coinsurance 30-Day Supply	Members In This Plan ID
CIGNA Medicare Access Plan One (PFFS) - H2762-020-0 Benefit Details			Otsego	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	13,290 members

CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-042-0 Benefit Details			Otsego	$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

SecureHorizons MedicareComplete Choice (Regional PPO) - R5342-001-0 Benefit Details			Otsego	$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%	13,222 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
SecureHorizons MedicareComplete Choice (Regional PPO) - R5342-001-0 Benefit Details			Statewide	$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%	13,222 members Browse Formulary

SecureHorizons MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Benefit Details			Otsego	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	748 members

SecureHorizons MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Benefit Details			Statewide	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	748 members

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Today's Options Value (PFFS) - H3333-039-0 Benefit Details			Otsego	$10.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	956 members

Evercare Plan RDP (Regional PPO) - R5342-003-0 Benefit Details			Otsego	$ 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%	4,933 members Browse Formulary

Evercare Plan RDP (Regional PPO) - R5342-003-0 Benefit Details			Statewide	$ 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%	4,933 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Evercare Plan RMP (Regional PPO) - R5342-004-0 Benefit Details			Otsego	$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%	n/a Browse Formulary

Evercare Plan RMP (Regional PPO) - R5342-004-0 Benefit Details			Statewide	$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%	n/a Browse Formulary

CDPHP Core (PPO) - H5042-002-0 Benefit Details			Otsego	$28.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	88 members
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Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Today's Options Value powered by CCRx (PFFS) - H3333-057-0 Benefit Details			Otsego	$29.00	$0	No Gap Coverage	Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33%	843 members Browse Formulary

Independent Health Medicare Anywhere Basic (PFFS) - H9519-003-0 Benefit Details			Otsego	$33.30	$0	Few Generics, Few Brand	Tier 1: $8.00 Tier 2: $45.00 Tier 3: $75.00 Specialty Tier 4: 33%	79 members Browse Formulary
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Humana Gold Choice H4774-002 (PFFS) - H4774-002-0 Benefit Details			Otsego	$40.00	$0	Few Generics, Few Brand	Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty: 33%	716 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
CIGNA Medicare Access Plan Three (PFFS) - H2762-024-0 Benefit Details			Otsego	$45.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	3,787 members

Medicare Blue PPO Plan FOUR (PPO) - H3335-044-0 Benefit Details			Otsego	$45.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	< 10 members

CDPHP Classic (PPO) - H5042-004-0 Benefit Details			Otsego	$49.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	136 members
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Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Today's Options Premier (PFFS) - H3333-033-0 Benefit Details			Otsego	$49.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	2,587 members

CDPHP Core Rx (PPO) - H5042-005-0 Benefit Details			Otsego	$49.60	$310	No Gap Coverage	Tier 1 Formulary Preferred Generics: $2.00 Tier 2 Formulary Non-Preferred Generics: $4.00 Tier 3 Formulary Preferred Brand: $35.00 Tier 4 Formulary Non-Preferred Brand: $70.00 Tier 5 Formulary Specialty: 25%	290 members Browse Formulary
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Medicare Blue PPO Plan ONE (PPO) - H3335-039-0 Benefit Details			Otsego	$51.00	$150	No Gap Coverage	Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 25%	88 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Humana Gold Choice H4774-005 (PFFS) - H4774-005-0 Benefit Details			Otsego	$52.00	$310	No Gap Coverage	Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25%	943 members Browse Formulary

Humana Gold Choice H4774-001 (PFFS) - H4774-001-0 Benefit Details			Otsego	$72.00	$0	Few Generics, Few Brand	Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33%	2,202 members Browse Formulary

Medicare Blue PPO - TWO (PPO) - H3335-017-0 Benefit Details			Otsego	$78.00	$0	Many Generics	Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 33%	369 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
CDPHP Classic Rx (PPO) - H5042-001-0 Benefit Details			Otsego	$79.60	$0	Many Generics	Tier 1 Formulary Preferred Generics: $2.00 Tier 2 Formulary Non-Preferred Generics: $4.00 Tier 3 Formulary Preferred Brand: $35.00 Tier 4 Formulary Non-Preferred Brand: $70.00 Tier 5 Formulary Specialty: 30%	2,229 members Browse Formulary
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CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-050-0 Benefit Details			Otsego	$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

Today's Options Premier powered by CCRx (PFFS) - H3333-051-0 Benefit Details			Otsego	$92.00	$0	All Generics	Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33%	598 members Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Medicare Blue PPO - THREE (PPO) - H3335-018-0 Benefit Details			Otsego	$93.00	$0	No Gap Coverage	Tier 1: $5.00 Tier 2: $30.00 Tier 3: $75.00 Tier 4: 33%	570 members Browse Formulary

Sterling Basic Plus (PFFS) - H5006-018-3 Benefit Details			Otsego	$109.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	10,911 members

CDPHP Prime (PPO) - H5042-006-0 Benefit Details			Otsego	$120.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	< 10 members
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Plan Name			County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Independent Health Medicare Anywhere (PFFS) - H9519-001-0 Benefit Details			Otsego	$135.00	$0	Few Generics, Few Brand	Tier 1: $8.00 Tier 2: $40.00 Tier 3: $70.00 Specialty Tier 4: 33%	156 members Browse Formulary
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Sterling Option II (PFFS) - H5006-017-3 Benefit Details			Otsego	$170.00	$225	No Gap Coverage	Generic: $10.00 Brand: $34.00 Specialty: 25%	8,639 members Browse Formulary

CDPHP Prime Rx (PPO) - H5042-007-0 Benefit Details			Otsego	$170.60	$0	Many Generics	Tier 1 Formulary Preferred Generics: $2.00 Tier 2 Formulary Non-Preferred Generics: $4.00 Tier 3 Formulary Preferred Brand: $35.00 Tier 4 Formulary Non-Preferred Brand: $70.00 Tier 5 Formulary Specialty: 30%	168 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	County	Monthly Prem.	Deduct- ible	Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	Plan ID Members
Sterling Option I (PFFS) - H5006-014-3 Benefit Details			Otsego	$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			Otsego	$196.00	$225	No Gap Coverage	Generic: $10.00 Brand: $36.00 Specialty: 25%	3,337 members Browse Formulary

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Chart Legend:

Below are a few notes to help with the understanding of the 2010 Medicare Advantage Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

A few notes to help with the understanding of the 2010 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)

CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.

This is a 1 to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor. (updated: November 2008)

Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.

This category includes measures of how drug plans rate on the following areas:
- Time on Hold When Customer and Pharmacist Calls Drug Plan.
- Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
- Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
- Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.

Member Plan Exper. - Member Experience with Drug Plan - This category shows how well drug plans make prescription drugs available to their members.

This category includes measures of how drug plans rate on the following areas:
- Drug Plan Provides Information or Help When Members Need It.
- Members’ Overall Rating of Drug Plan.
- Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.

RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.

This category includes measures of how drug plans rate on the following areas:
- Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
- Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
- Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
- Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
- Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.

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County: Medicare Advantage Plans are only available in specific county and in some cases on in part of a county. This field will note the county where the plan is available or in some cases, "Statewide" if the plan is available in every county. (Search Tip: You must enter your 5 digit ZIP Code in the criteria field to begin your search. We will determine your county from your ZIP code and only show appropriate plans.)
Monthly Premium: This is the amount you must pay each month to use the plan. For the Medicare Advantage Plans shown above, this premium includes Medicare Part C AND Part D (if the plan has prescription drug coverage). This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)
Deductible: This is the $310 deductible that was presented in the CMS Standard Plan. Many provider’s plans do not have a deductible, however the premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible field" field.)

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Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3610 in drug costs (the Donut Hole). Many provider’s plans cover the costs that fall into this category for an additional premium. In our chart, you will see one of the following:
- No Rx Cov.: This plan does not include prescription drug coverage. You are 100% responsible for your medication costs. If you would like to see ONLY those plans that do include some type of prescription coverage, please select ":Show only plans WITH Drug Coverage" in the "Prescription Drug Coverage" selector above (this is the default setting);
- No Gap Coverage: you must pay the $3610;
- All Generics, All Brand: All formulary generics and all formulary Brand drugs are covered through the donut hole. This gap coverage option is availalbe in many counties in MN (HealthPartners Freedom Plan III EnhancedRx (Cost Plan)), a few counties in CA (Advantage I MAPD (HMO), CareMore Value Plus (HMO), Central Health Medicare Plan (HMO)), and in Dade county, FL (Medica HealthCare Plans MedicareMax(PSO));
- All Generics, Some Brand: All formulary generics and a some (10% to 65%) of formulary Brands are covered through the donut hole;
- All Generics, Few Brand: All formulary generics and a few (less than 10%) of formulary Brands are covered through the donut hole;
- All Generics: All formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3610;
- Many Generics, Many Brand: Many formulary generics (65% to 100%) and a many (65% to 100%) formulary Brands are covered through the donut hole;
- Many Generics, Some Brand: Many formulary generics (65% to 100%) and a some (10% to 65%) formulary Brands are covered through the donut hole;
- Many Generics, Few Brand: Many formulary generics (65% to 100%) and a few (less than 10%) formulary Brands are covered through the donut hole;
- Many Generics: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3610;
- Some Generics, Few Brand: Some formulary generics (10% to 65%) and a few (less than 10%) formulary Brands are covered through the donut hole;
- Some Generics: 10% to 65% of formulary generics are covered, but you must pay for Brand Drugs up to $3610;
- Few Generics, Few Brand: Less than 10% of formulary generics and a few (less than 10%) formulary Brands are covered through the donut hole;
- Few Generics: Less than 10% of formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3610;
Plan ID: This is the unique id for this particular plan.

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Copay / Coinsurance - Cost Sharing - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)

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Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)

Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.
Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.
Members in This State (updated: September 2009 figures) - This is the total number of members in this plan for this CMS Region. For regions which contain more than one state, this is the total for all of those states combined. We are showing the latest Medicare Advantage plan enrollment figures. We update this figure as new enrollment statistics are released by Medicare.

MOOP ≤ $3,400 for Part A & B Benefits - MOOP is the Maximum Out-of-Pocket limit set by the Medicare Advantage Plan. Yes means that the Medicare Advantage plan does limit the beneficiaries yearly maximum out of pocket cost-sharing expenditure (co-payments / co-insurance) for Medicare Parts A & B (NOT Part D - prescription drug cost-sharing) to $3,400. No means that the Medicare Advantage plan does NOT limit the beneficiaries yearly maximum out of pocket cost-sharing expenditure (co-payments / co-insurance) for Medicare Parts A & B (NOT Part D - prescription drug cost-sharing) to $3,400.
Health Plan Type - This the organization type for the Medicare Advantage Plan. This could be Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), etc. (Search Tip: If you would like to limit your search to a specific type of Medicare Advantage Plans, please select the health plan type in the "Type of Health Coverage" field.);
SNP Eligibility Requirements - Special Needs Plans (SNPs) have an eligibility requirement whereas all other Medicare Advantage plans do not. (Search Tip: If you would like to limit your search to specific types of Special Needs Medicare Advantage Plans, please check the appropriate boxes in the "Special Needs Plans (SNP) Options" field.)

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(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the Medicare.gov website plan finder.)

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information.

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2010 Medicare Advantage Plans: SNPs, Health (MAs), Health & Rx Drug (MA-PDs)

2010 Medicare Advantage Plans: SNPs,
Health (MAs), Health & Rx Drug (MA-PDs)