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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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Care Improvement Plus Gold Rx (Regional PPO) - R9896-009-0 Benefit Details |
Allendale | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO) - R9896-009-0 Benefit Details |
Statewide | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Guardian Tribute (PFFS) - H4917-001-0 Benefit Details |
Allendale | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | 9,349 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 | |||||||||
Guardian Tribute Pride Plan (PFFS) - H4917-003-0 Benefit Details |
Allendale | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 8,495 members | ||||||
new | new | new | |||||||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Allendale | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,697 members | ||||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 2,697 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Blue Private (PFFS) - H4205-004-0 Benefit Details |
Allendale | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 782 members | ||||||
new | new | new | |||||||||
Presidential Plan (PFFS) - H9720-025-0 Benefit Details |
Allendale | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 141 members | ||||||
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SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Allendale | $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 | |||||||||
Southeast Community Care- Plus (HMO) - H5783-009-0 Benefit Details |
Allendale | $0.00 | $0 | Some Generics | Tier 1 - Preferred Generic: $3.00 Tier 2 - Non-Preferred Generic: $12.00 Tier 3 - Preferred Brand: $44.00 Tier - Non-Preferred Brand: $79.00 Tier 5 - Specialty: Lesser of $300 or 33%: -200% | 113 members Browse Formulary | |||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R9896-010-0 Benefit Details |
Allendale | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R9896-010-0 Benefit Details |
Statewide | $14.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary 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 | |||||||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Allendale | $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 | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R9896-008-0 Benefit Details |
Allendale | $32.50 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R9896-008-0 Benefit Details |
Statewide | $32.50 | $0 | No Gap Coverage | Formulary Generic: $0.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary 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 | |||||||||
Presidential Plus Plan (PFFS) - H9720-026-0 Benefit Details |
Allendale | $45.00 | $0 | No Gap Coverage | Tier 1: $0.00 Tier2: $45.00 Tier 3: $75.00 Tier 4: 33% | 117 members Browse Formulary | |||||
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Any, Any, Any MA Only (PFFS) - H5820-029-0 Benefit Details |
Allendale | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 872 members | ||||||
Guardian Tribute Enhanced (PFFS) - H4917-002-0 Benefit Details |
Allendale | $49.00 | $0 | Many Generics | Generic: $0.00 Preferred Generic: $4.00 Non-Preferred Generic: $12.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty: 33% | 749 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 | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Allendale | $50.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $37.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Statewide | $50.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $37.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | n/a Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-014-0 Benefit Details |
Allendale | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 215 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Blue Private Complete (PFFS) - H4205-006-0 Benefit Details |
Allendale | $56.00 | $0 | Many Generics | Value Generics: $3.00 Generics: $11.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty: 33% | 539 members Browse Formulary | |||||
new | new | new | |||||||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Allendale | $57.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 148 members Browse Formulary | |||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Statewide | $57.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 148 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any Gold (PFFS) - H5820-011-0 Benefit Details |
Allendale | $59.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 15,561 members Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
Allendale | $59.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $84.00 Specialty: 33% | 14,668 members Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
Statewide | $59.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $84.00 Specialty: 33% | 14,668 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Blue (PPO) - H4209-003-0 Benefit Details |
Allendale | $59.00 | $0 | No Gap Coverage | Generics: $10.00 Preferred Brand: $39.00 Non-Preferred Brand: $75.00 Specialty: 33% | 222 members Browse Formulary | |||||
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Today's Options Value (PFFS) - H5421-165-0 Benefit Details |
Allendale | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,006 members | ||||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-032-0 Benefit Details |
Allendale | $70.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 942 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 powered by CCRx (PFFS) - H5421-166-0 Benefit Details |
Allendale | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 3,797 members Browse Formulary | |||||
Humana Gold Choice H2944-146 (PFFS) - H2944-146-0 Benefit Details |
Allendale | $79.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 3,242 members Browse Formulary | |||||
Any, Any, Any Platinum (PFFS) - H5820-013-0 Benefit Details |
Allendale | $89.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 612 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Blue Private Complete Plus (PFFS) - H4205-008-0 Benefit Details |
Allendale | $100.00 | $0 | Many Generics | Value Generics: $3.00 Generics: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty: 33% | 457 members Browse Formulary | |||||
new | new | new | |||||||||
Today's Options Premier (PFFS) - H5421-163-0 Benefit Details |
Allendale | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 6,062 members | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-018-0 Benefit Details |
Allendale | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 151 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Medicare Blue Plus (PPO) - H4209-006-0 Benefit Details |
Allendale | $121.00 | $0 | Many Generics | Value Generics: $2.00 Generics: $9.00 Value Preferred Brand: $25.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty: 33% | 255 members Browse Formulary | |||||
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CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-040-0 Benefit Details |
Allendale | $145.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 254 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-164-0 Benefit Details |
Allendale | $151.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,969 members Browse Formulary | |||||
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