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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 Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Pickaway | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 995 members | ||||||
Blue Medicare Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 995 members | ||||||
Blue Medicare Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Pickaway | $0.00 | $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% | 14,988 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 Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Statewide | $0.00 | $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% | 14,988 members Browse Formulary | |||||
HumanaChoice R5826-021 (Regional PPO) - R5826-021-0 Benefit Details |
Pickaway | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,037 members | ||||||
HumanaChoice R5826-021 (Regional PPO) - R5826-021-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,037 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Aetna Medicare Open Basic Plan (PFFS) - H5736-018-0 Benefit Details |
Pickaway | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 761 members | ||||||
Molina Medicare Options (HMO) - H0490-001-0 Benefit Details |
Pickaway | $24.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Drug: 33% | 24 members Browse Formulary | |||||
new | new | new | |||||||||
Blue Medicare Access Standard (Regional PPO) - R5941-001-0 Benefit Details |
Pickaway | $30.00 | $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% | 14,803 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 Access Standard (Regional PPO) - R5941-001-0 Benefit Details |
Statewide | $30.00 | $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% | 14,803 members Browse Formulary | |||||
Humana Gold Choice H2944-121 (PFFS) - H2944-121-0 Benefit Details |
Pickaway | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $9.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 3,313 members Browse Formulary | |||||
HumanaChoice H3619-012 (PPO) - H3619-012-0 Benefit Details |
Pickaway | $40.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 2,068 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Aetna Medicare Open Value Plan w/Rx (PFFS) - H5736-003-0 Benefit Details |
Pickaway | $44.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $8.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $34.00 Tier 4 - Non-Preferred Brand: $74.00 Tier 5 - Specialty: 25% | n/a Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-013-0 Benefit Details |
Pickaway | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 337 members | ||||||
Advantage Plan Securex (HMO-POS) - H9313-007-0 Benefit Details |
Pickaway | $58.00 | $0 | No Gap Coverage | Preferred Generic: $4.00 Non-Preferred Generic: $15.00 Preferred Brand: $50.00 Non-Preferred Brand: $90.00 Specialty: 33% | 911 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) - H2762-030-0 Benefit Details |
Pickaway | $60.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | n/a Browse Formulary | |||||
HumanaChoice R5826-080 (Regional PPO) - R5826-080-0 Benefit Details |
Pickaway | $61.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 181 members Browse Formulary | |||||
HumanaChoice R5826-080 (Regional PPO) - R5826-080-0 Benefit Details |
Statewide | $61.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 181 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 Value (PFFS) - H5421-165-0 Benefit Details |
Pickaway | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
Humana Gold Choice H2944-129 (PFFS) - H2944-129-0 Benefit Details |
Pickaway | $67.00 | $0 | Few Generics, Few Brand | Preferred Generic: $9.00 Non-Preferred Generic/Preferred Brand: $41.00 Non-Preferred Brand: $80.00 Specialty: 33% | 12,516 members Browse Formulary | |||||
HumanaChoice R5826-007 (Regional PPO) - R5826-007-0 Benefit Details |
Pickaway | $69.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $82.00 Specialty: 33% | 7,690 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-007 (Regional PPO) - R5826-007-0 Benefit Details |
Statewide | $69.00 | $0 | Few Generics, Few Brand | Preferred Generic: $10.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $82.00 Specialty: 33% | 7,690 members Browse Formulary | |||||
MediGold Essential Care (HMO) - H3668-011-0 Benefit Details |
Pickaway | $72.00 | $0 | No Gap Coverage | Value Generics: $10.00 Generic: $15.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Drugs: 25% | 525 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Pickaway | $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 | |||||||||
MediGold Classic Preferred (HMO) - H3668-005-0 Benefit Details |
Pickaway | $99.00 | $0 | Many Generics | Value Generic: $5.00 Generic: $10.00 Preferred Brand: $25.00 Non-Preferred Brand: $40.00 Specialty Drugs: 25% | 25,931 members Browse Formulary | |||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-017-0 Benefit Details |
Pickaway | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 165 members | ||||||
Today's Options Premier (PFFS) - H5421-163-0 Benefit Details |
Pickaway | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
MediGold Medical Only (HMO) - H3668-013-0 Benefit Details |
Pickaway | $124.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 465 members | ||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-038-0 Benefit Details |
Pickaway | $135.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 442 members Browse Formulary | |||||
MediGold Network Choice (PPO) - H1846-001-0 Benefit Details |
Pickaway | $147.00 | $0 | Many Generics | Value Generic: $5.00 Generic: $10.00 Preferred Brand: $25.00 Non-Preferred Brand: $40.00 Specialty Drugs: 25% | 708 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 | |||||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Pickaway | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
Advantage Plan Optimumx (HMO-POS) - H9313-012-1 Benefit Details |
Pickaway | $170.00 | $0 | Many Generics | Preferred Generic: $4.00 Non-Preferred Generic: $15.00 Preferred Brand: $50.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | 319 members Browse Formulary | |||||
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