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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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Health Net Violet Option 2 (PPO) - H5520-006-0 Benefit Details |
Jackson | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic: $6.00 Tier 2 Preferred Brand: $38.00 Tier 3 Non-Preferred: $76.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 2,126 members Browse Formulary | |||||
Trillium Advantage Dual SNP (HMO) - H2174-001-0 Benefit Details |
Jackson | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Preferred Generic: $0.00 Preferred Brand: $45.00 Specialty: 25% Non-Preferred: $95.00 | 2,447 members Browse Formulary | |||||
CareSource Silver (HMO) - H3810-006-0 Benefit Details |
Jackson | $23.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 107 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Health Net Aqua (PPO) - H5520-003-0 Benefit Details |
Jackson | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
CareOregon Advantage Star (HMO) - H5859-003-0 Benefit Details |
Jackson | $26.40 | $310 | Many Generics | 1: $0.00 2: $45.00 3: 25% | 343 members Browse Formulary | |||||
Trillium Advantage ISNP (HMO) - H2174-003-0 Benefit Details |
Jackson | $31.00 | $310 | No Gap Coverage | Tier 1: 25% | 31 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CareOregon Advantage Plus (HMO) - H5859-001-0 Benefit Details |
Jackson | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | 1: $0.00 2: 41% 3: 25% | 5,798 members Browse Formulary | |||||
CareSource - SNP (HMO) - H3810-002-0 Benefit Details |
Jackson | $ 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% | n/a Browse Formulary | |||||
Trillium Advantage Community ISNP (HMO) - H2174-005-0 Benefit Details |
Jackson | $35.60 | $310 | No Gap Coverage | Tier 1: 25% | < 10 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CareSource Silver Plus Rx (HMO) - H3810-007-0 Benefit Details |
Jackson | $54.60 | $0 | No Gap Coverage | Generic: $5.00 Brand: $39.00 Non-preferred Brand: $69.00 Specialty: 3,300% | 290 members Browse Formulary | |||||
CareSource Gold (HMO) - H3810-001-0 Benefit Details |
Jackson | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 429 members | ||||||
Sterling Basic Plus (PFFS) - H5006-018-2 Benefit Details |
Jackson | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Trillium Advantage Flex (HMO) - H2174-004-0 Benefit Details |
Jackson | $60.30 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 126 members | ||||||
Today's Options Value (PFFS) - H5421-057-0 Benefit Details |
Jackson | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 598 members | ||||||
Today's Options Value powered by CCRx (PFFS) - H5421-075-0 Benefit Details |
Jackson | $67.60 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 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 | |||||||||
Health Net Violet Option 1 (PPO) - H5520-004-0 Benefit Details |
Jackson | $75.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic: $6.00 Tier 2 Preferred Brand: $38.00 Tier 3 Non-Preferred: $76.00 Tier 4 Injectable: 33% Tier 5 Specialty: 33% | 3,542 members Browse Formulary | |||||
CareSource Gold (HMO) - H3810-008-0 Benefit Details |
Jackson | $79.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 106 members | ||||||
CareSource Diamond (PPO) - H2481-003-0 Benefit Details |
Jackson | $91.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 13 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 | |||||||||
Sterling Option I (PFFS) - H5006-014-2 Benefit Details |
Jackson | $94.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Today's Options Premier (PFFS) - H5421-051-0 Benefit Details |
Jackson | $99.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 696 members | ||||||
Health Net Healthy Heart (PPO) - H5520-010-0 Benefit Details |
Jackson | $101.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic: $5.00 Tier 2 Preferred Brand: $35.00 Tier 3 Non-Preferred: $70.00 Tier 4 Injectable: 33% Tier 5 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 | |||||||||
Sterling Option II (PFFS) - H5006-017-2 Benefit Details |
Jackson | $107.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
CareSource Platinum (HMO-POS) - H3810-004-0 Benefit Details |
Jackson | $113.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 41 members | ||||||
CareSource Gold Plus Rx (HMO) - H3810-003-0 Benefit Details |
Jackson | $114.60 | $0 | No Gap Coverage | Generic: $5.00 Brand: $39.00 Non-preferred Brand: $69.00 Specialty: 3,300% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Regence MedAdvantage (PPO) - H3817-001-0 Benefit Details |
Jackson | $116.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,130 members | ||||||
Sterling Option IV (PFFS) - H5006-016-2 Benefit Details |
Jackson | $120.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
Trillium Advantage (HMO) - H2174-002-0 Benefit Details |
Jackson | $125.00 | $0 | Many Generics | Preferred Generic: $9.00 Preferred Brand: $30.00 Non-Preferred: $50.00 | 438 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Regence MedAdvantage + Rx Classic (PPO) - H3817-002-0 Benefit Details |
Jackson | $126.00 | $200 | No Gap Coverage | Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Brand: $56.00 Miscellaneous Injectables: 27% Specialty: 27% | 23,022 members Browse Formulary | |||||
ODS Advantage PPO (PPO) - H3813-001-0 Benefit Details |
Jackson | $126.10 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 70 members | ||||||
CareSource Gold Plus Rx (HMO) - H3810-010-0 Benefit Details |
Jackson | $134.70 | $0 | No Gap Coverage | Generic: $5.00 Brand: $39.00 Non-preferred Brand: $69.00 Specialty: 3,300% | 278 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CareSource Diamond Plus Rx (PPO) - H2481-004-0 Benefit Details |
Jackson | $142.60 | $0 | No Gap Coverage | Generic: $5.00 Brand: $39.00 Non-preferred Brand: $69.00 Specialty: 3,300% | 54 members Browse Formulary | |||||
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CareSource Platinum Plus Rx (HMO-POS) - H3810-005-0 Benefit Details |
Jackson | $150.70 | $0 | No Gap Coverage | Generic: $5.00 Brand: $39.00 Non-preferred Brand: $69.00 Specialty: 3,300% | 300 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-069-0 Benefit Details |
Jackson | $153.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 387 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Regence MedAdvantage + Rx Enhanced (PPO) - H3817-003-0 Benefit Details |
Jackson | $176.00 | $0 | Many Generics | Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Brand: $56.00 Miscellaneous Injectables: 30% Specialty: 30% | 22,389 members Browse Formulary | |||||
Trillium Advantage Deluxe Community ISNP (HMO) - H2174-006-0 Benefit Details |
Jackson | $194.00 | $0 | No Gap Coverage | Preferred Generic: $9.00 Preferred Brand: $30.00 Non-Preferred: $50.00 | < 10 members Browse Formulary | |||||
ODS Advantage PPORX Select (PPO) - H3813-003-0 Benefit Details |
Jackson | $223.70 | $0 | All Generics | Tier 1: tbd | 248 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
ODS Advantage PPORX (PPO) - H3813-002-0 Benefit Details |
Jackson | $231.90 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% | 103 members Browse Formulary | |||||
Trillium Advantage Deluxe ISNP (HMO) - H2174-007-0 Benefit Details |
Jackson | $244.00 | $0 | No Gap Coverage | Preferred Generic: $9.00 Preferred Brand: $30.00 Non-Preferred: $50.00 | < 10 members Browse Formulary | |||||
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