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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) |
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(Donut Hole) Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
Members In This Plan ID | |||||
Cust. Service Rating |
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AARP MedicareComplete (HMO) - H4590-010-0 Benefit Details |
Bexar | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $29.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $60.00 Tier 4 Specialty: 33% | 32,123 members Browse Formulary | |||||
AARP MedicareComplete Essential (HMO) - H4590-029-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Advantra (PPO) - H7306-001-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Preferred Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Generic/Non-Preferred Brand: $70.00 Specialty-Generic and Brand: 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 | |||||||||
Aetna Medicare Dual Advantage Plan (HMO) - H4523-014-0 Benefit Details |
Bexar | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $20.00 Tier 3 - Preferred Brand: $30.00 Tier 4 - Non-Preferred Brand: $70.00 Tier 5 - Specialty: 25% | 467 members Browse Formulary | |||||
Aetna Medicare Premier Plan (HMO) - H4523-001-0 Benefit Details |
Bexar | $0.00 | $0 | Many Generics | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | n/a Browse Formulary | |||||
Aetna Medicare Value Plan (PPO) - H4524-001-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Tier 1 - Preferred Generic: $9.00 Tier 2 - Non-Preferred Generic: $32.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 25% | 649 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 | |||||||||
Amerivantage Balance + Rx (HMO) - H5817-011-0 Benefit Details |
Bexar | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $20.00 Non-Preferred Brand Drugs: $60.00 Specialty Drugs: 33% | 517 members Browse Formulary | |||||
Amerivantage Classic + Rx (HMO) - H5817-010-0 Benefit Details |
Bexar | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $70.00 Specialty Drugs: 33% | 560 members Browse Formulary | |||||
Bravo Achieve (HMO) - H4528-015-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 33% Preferred Diabetic Drugs: $0.00 | 289 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Bravo Classic Plus (HMO-POS) - H4528-005-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Generic: $3.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty: 33% | 2,118 members Browse Formulary | |||||
Bravo Liberty I (PFFS) - H7406-006-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 108 members | ||||||
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Bravo Liberty II Rx (PFFS) - H7406-004-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 186 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 | |||||||||
Bravo Liberty Silver (PFFS) - H7406-011-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 174 members | ||||||
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Care Improvement Plus Gold Rx (Regional PPO) - R6801-009-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 8,547 members Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO) - R6801-009-0 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% | 8,547 members Browse Formulary | |||||
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 (PPO) - H0084-001-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $39.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 775 members Browse Formulary | |||||
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CIGNA Medicare Access Plan One (PFFS) - H2762-012-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,544 members | ||||||
Evercare Plan MH (HMO) - H4590-037-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $37.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $71.00 Tier 4 Specialty: 33% | 2,194 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
FRESENIUS MEDICAL CARE HEALTH PLAN (PFFS) - H5962-001-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 198 members | ||||||
Humana Gold Plus H4510-015 (HMO) - H4510-015-0 Benefit Details |
Bexar | $0.00 | $0 | Some Generics, Few Brand | Preferred Generic: $0.00 Non-Preferred Generic/Preferred Brand: $20.00 Non-Preferred Brand: $45.00 Specialty: 33% | 19,499 members Browse Formulary | |||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,537 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,537 members | ||||||
Molina Medicare Options (HMO) - H7678-002-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty Drug: 33% | 68 members Browse Formulary | |||||
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SecureHorizons MedicareDirect Plan 1 (PFFS) - H5435-001-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 27,113 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Today's Options Advantage 1 powered by CCRx (PPO) - H5378-176-0 Benefit Details |
Bexar | $0.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,058 members Browse Formulary | |||||
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Today's Options Premier (PFFS) - H5421-046-0 Benefit Details |
Bexar | $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 |
Bexar | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 740 members | ||||||
Evercare Plan DH (HMO) - H4590-022-0 Benefit Details |
Bexar | $ 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% | 7,857 members Browse Formulary | |||||
Today's Options Advantage 2 powered by CCRx (PPO) - H5378-190-0 Benefit Details |
Bexar | $11.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 372 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 | |||||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R6801-010-0 Benefit Details |
Bexar | $12.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 2,341 members Browse Formulary | |||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R6801-010-0 Benefit Details |
Statewide | $12.00 | $0 | No Gap Coverage | Formulary Generic: $4.00 Formulary Preferred Brand: $45.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 2,341 members Browse Formulary | |||||
Any, Any, Any MA Only (PFFS) - H5820-027-0 Benefit Details |
Bexar | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 162 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) - H2762-028-0 Benefit Details |
Bexar | $20.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 7,225 members Browse Formulary | |||||
SecureHorizons MedicareDirect Rx Plan 51 (PFFS) - H5435-014-0 Benefit Details |
Bexar | $20.00 | $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: $80.00 Tier 4 Specialty: 33% | 61,945 members Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) - H5421-070-0 Benefit Details |
Bexar | $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 | |||||
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 |
Bexar | $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 | |||||
SecureHorizons MedicareDirect Plan 100 (PFFS) - H5435-020-0 Benefit Details |
Bexar | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,121 members | ||||||
Humana Gold Plus SNP-DE H4510-017 (HMO) - H4510-017-0 Benefit Details |
Bexar | $ 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 Non-Preferred Generic/Preferred Brand: $30.00 Non-Preferred Brand: $60.00 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 | |||||||||
Superior HealthPlan (HMO) - H5294-001-0 Benefit Details |
Bexar | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Injectables: $95.00 | 226 members Browse Formulary | |||||
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Amerivantage Specialty + Rx (HMO) - H5817-009-0 Benefit Details |
Bexar | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Preferred Generic Drugs: $0.00 Non-Preferred Generic Drugs: $0.00 Preferred Brand Drugs: $47.00 Non-Preferred Brand Drugs: $90.00 Specialty Drugs: 25% | 5,568 members Browse Formulary | |||||
Bravo Select (HMO) - H4528-006-0 Benefit Details |
Bexar | $ 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% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Bravo Traditions (HMO) - H4528-013-0 Benefit Details |
Bexar | $27.50 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | < 10 members Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R6801-008-0 Benefit Details |
Bexar | $27.50 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $43.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,489 members Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO) - R6801-008-0 Benefit Details |
Statewide | $27.50 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $43.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 4,489 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Fidelis Secure Comfort (HMO) - H5980-005-0 Benefit Details |
Bexar | $27.50 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 122 members Browse Formulary | |||||
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Molina Medicare Options Plus (HMO) - H7678-001-0 Benefit Details |
Bexar | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty: 25% | 446 members Browse Formulary | |||||
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Care Improvement Plus Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Bexar | $33.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $39.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 2,438 members Browse Formulary | |||||
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) - R6801-012-0 Benefit Details |
Statewide | $33.00 | $0 | No Gap Coverage | Formulary Generic: $9.00 Formulary Preferred Brand: $39.00 Formulary Non-Preferred Brand: $95.00 Formulary Specialty: 33% | 2,438 members Browse Formulary | |||||
Any, Any, Any Gold (PFFS) - H5820-003-0 Benefit Details |
Bexar | $39.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 3,776 members Browse Formulary | |||||
Sterling Basic Plus (PFFS) - H5006-018-1 Benefit Details |
Bexar | $39.00 | 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 | |||||||||
Today's Options Advantage 3 powered by CCRx (PPO) - H5378-182-0 Benefit Details |
Bexar | $48.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 189 members Browse Formulary | |||||
new | new | new | |||||||||
Aetna Medicare Premier Plan (PPO) - H4524-002-0 Benefit Details |
Bexar | $50.00 | $0 | Many Generics | Tier 1 - Preferred Generic: $5.00 Tier 2 - Non-Preferred Generic: $30.00 Tier 3 - Preferred Brand: $40.00 Tier 4 - Non-Preferred Brand: $80.00 Tier 5 - Specialty: 33% | 382 members Browse Formulary | |||||
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HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Bexar | $51.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $44.00 Non-Preferred Brand: $80.00 Specialty: 33% | 35,590 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Statewide | $51.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $44.00 Non-Preferred Brand: $80.00 Specialty: 33% | 35,590 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-064-0 Benefit Details |
Bexar | $58.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 4,188 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
Bexar | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-016-0 Benefit Details |
Bexar | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 608 members | ||||||
Bravo Freedom (PPO) - H1355-001-0 Benefit Details |
Bexar | $61.00 | $0 | No Gap Coverage | Generic: $4.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Specialty: 33% | 81 members Browse Formulary | |||||
new | new | new | |||||||||
Any, Any, Any Platinum (PFFS) - H5820-009-0 Benefit Details |
Bexar | $69.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 137 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Fidelis Secure Comfort Plus (HMO) - H5980-006-0 Benefit Details |
Bexar | $70.00 | $0 | No Gap Coverage | generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $65.00 Specialty: 33% | < 10 members Browse Formulary | |||||
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HumanaChoice H4520-001 (PPO) - H4520-001-0 Benefit Details |
Bexar | $71.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $44.00 Non-Preferred Brand: $80.00 Specialty: 33% | 696 members Browse Formulary | |||||
Humana Gold Choice H2944-026 (PFFS) - H2944-026-0 Benefit Details |
Bexar | $74.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 6,092 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-075 (Regional PPO) - R5826-075-0 Benefit Details |
Bexar | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 104 members Browse Formulary | |||||
HumanaChoice R5826-075 (Regional PPO) - R5826-075-0 Benefit Details |
Statewide | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 104 members Browse Formulary | |||||
Fidelis Secure Independence (HMO) - H5980-007-0 Benefit Details |
Bexar | $85.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred: $65.00 Specialty: 33% | < 10 members Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
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Preferred Pharmacy Copay/ Coinsurance |
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Service | Exper. | Cost Info | |||||||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-036-0 Benefit Details |
Bexar | $90.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 2,420 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
Bexar | $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 |
Bexar | $119.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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