$dynamicTitle=$dynamicTitle.' 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 |
|||||||||
Care Improvement Plus Gold Rx (Regional PPO) - R6801-009-0 Benefit Details |
Comanche | $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 | |||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Comanche | $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 | ||||||
SecureHorizons MedicareDirect Plan 1 (PFFS) - H5435-001-0 Benefit Details |
Comanche | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 27,113 members | ||||||
SecurityChoice Classic (PFFS) - H0540-001-0 Benefit Details |
Comanche | $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 | |||||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R6801-010-0 Benefit Details |
Comanche | $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 | |||||
SecureHorizons MedicareDirect Rx Plan 51 (PFFS) - H5435-014-0 Benefit Details |
Comanche | $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 | |||||
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 |
Comanche | $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 |
Comanche | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,121 members | ||||||
Care Improvement Plus Silver Rx (Regional PPO) - R6801-008-0 Benefit Details |
Comanche | $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 | |||||||||
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 | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Comanche | $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 | |||||
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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Rx Plan 150 (PFFS) - H5435-027-0 Benefit Details |
Comanche | $35.00 | $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% | 4,555 members Browse Formulary | |||||
Sterling Basic Plus (PFFS) - H5006-018-1 Benefit Details |
Comanche | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 10,911 members | ||||||
Any, Any, Any MA Only (PFFS) - H5820-028-0 Benefit Details |
Comanche | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 122 members | ||||||
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 |
Comanche | $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 | |||||
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 | |||||
HumanaChoice H4520-006 (PPO) - H4520-006-0 Benefit Details |
Comanche | $56.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $43.00 Non-Preferred Brand: $80.00 Specialty: 33% | 3,207 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) - H5820-004-0 Benefit Details |
Comanche | $59.00 | $0 | No Gap Coverage | Value Generic: $4.00 Generic: $10.00 Preferred Brand: $35.00 Non Preferred Brand: $70.00 Speciality: 33% | 2,337 members Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
Comanche | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
HumanaChoice R5826-075 (Regional PPO) - R5826-075-0 Benefit Details |
Comanche | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 104 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 |
Statewide | $76.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 104 members Browse Formulary | |||||
CIGNA Medicare Access Plan One (PFFS) - H2762-015-0 Benefit Details |
Comanche | $80.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 150 members | ||||||
Today's Options Value (PFFS) - H5421-173-0 Benefit Details |
Comanche | $85.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any Platinum (PFFS) - H5820-010-0 Benefit Details |
Comanche | $89.00 | $0 | No Gap Coverage | Value Generic: $2.00 Generic: $7.00 Preferred Brand: $30.00 Non Preferred Brand: $60.00 Speciality: 33% | 97 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-034-0 Benefit Details |
Comanche | $95.00 | $0 | No Gap Coverage | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | 627 members Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
Comanche | $99.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 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) - H5421-174-0 Benefit Details |
Comanche | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Sterling Option IV (PFFS) - H5006-016-1 Benefit Details |
Comanche | $119.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-171-0 Benefit Details |
Comanche | $124.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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) - H2762-019-0 Benefit Details |
Comanche | $135.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 members | ||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-172-0 Benefit Details |
Comanche | $186.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
|