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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. |
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AARP MedicareComplete (HMO) - H4590-012-0 Benefit Details |
Johnson | $0.00 | $0 | Many Generics | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $39.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $74.00 Tier 4 Specialty: 33% | 77,638 members Browse Formulary | |||||
AARP MedicareComplete Essential (HMO) - H4590-027-0 Benefit Details |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Advantra (PPO) - H7306-001-0 Benefit Details |
Johnson | $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 | |||||||||
Bravo Liberty I (PFFS) - H7406-006-0 Benefit Details |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 108 members | ||||||
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Bravo Liberty Silver (PFFS) - H7406-011-0 Benefit Details |
Johnson | $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 |
Johnson | $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 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 | |||||
Care Improvement Plus Medicare Advantage (PPO) - H0084-001-0 Benefit Details |
Johnson | $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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Care N' Care Health Plan II MA-Only (PPO) - H6328-006-0 Benefit Details |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 57 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 | |||||||||
Care N' Care Health Plan III (PPO) - H6328-003-0 Benefit Details |
Johnson | $0.00 | $0 | Many Generics | Preferred Generic: $2.00 Preferred Brand: $35.00 Non- Preferred Drugs: $65.00 Specialty: 33% | 479 members Browse Formulary | |||||
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CIGNA Medicare Access Plan One (PFFS) - H2762-012-0 Benefit Details |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 3,544 members | ||||||
Evercare Plan MH (HMO) - H4590-035-0 Benefit Details |
Johnson | $0.00 | $0 | No Gap Coverage | Tier 1 Preferred Generic Brand: $5.00 Tier 2 Generic Preferred Brand: $45.00 Tier 3 Non-Preferred Generic Non-Preferred Brand: $85.00 Tier 4 Specialty: 33% | 5,555 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 5,537 members | ||||||
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 |
Johnson | $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 |
Johnson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 22,271 members | ||||||
Care Improvement Plus Gold Rx Advantage (Regional PPO) - R6801-010-0 Benefit Details |
Johnson | $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 | |||||
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) - H5421-054-0 Benefit Details |
Johnson | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Evercare Plan DH (HMO) - H4590-020-0 Benefit Details |
Johnson | $ 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% | 5,504 members Browse Formulary | |||||
CIGNA Medicare Access Plus RX Plan Two (PFFS) - H2762-028-0 Benefit Details |
Johnson | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Rx Plan 51 (PFFS) - H5435-014-0 Benefit Details |
Johnson | $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 | |||||
SecurityChoice Plus (PFFS) - H0540-020-0 Benefit Details |
Johnson | $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 |
Johnson | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,121 members | ||||||
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 |
Johnson | $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 | |||||
Care N' Care Health Plan II (PPO) - H6328-002-0 Benefit Details |
Johnson | $29.00 | $0 | Many Generics | Preferred Generic: $0.00 Preferred Brand: $33.00 Non- Preferred Drugs: $65.00 Specialty: 33% | 588 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 N' Care Health Plan I MA-Only (PPO) - H6328-005-0 Benefit Details |
Johnson | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 18 members | ||||||
new | new | new | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Johnson | $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 | |||||||||
HealthSpring HealthyAdvantage Plus (PPO) - H7787-004-0 Benefit Details |
Johnson | $35.00 | $0 | Many Generics, Few Brand | Preferred Generic: $2.50 Generic: $7.50 Preferred Brand: $40.00 Non-Preferred Brand: 33% Specialty: 33% | 467 members Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) - H5421-072-0 Benefit Details |
Johnson | $37.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 2,615 members Browse Formulary | |||||
Sterling Basic Plus (PFFS) - H5006-018-1 Benefit Details |
Johnson | $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 | |||||||||
Any, Any, Any MA Only (PFFS) - H5820-029-0 Benefit Details |
Johnson | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 872 members | ||||||
Today's Options Premier (PFFS) - H5421-048-0 Benefit Details |
Johnson | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HealthSpring HealthyAdvantage Premier (PPO) - H7787-005-0 Benefit Details |
Johnson | $50.00 | $0 | Many Generics, Few Brand | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty: 33% | 577 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 | |||||||||
HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Johnson | $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 |
Johnson | $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) - H5820-011-0 Benefit Details |
Johnson | $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 | |||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
Johnson | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 43,891 members | ||||||
CIGNA Medicare Access Plan Three (PFFS) - H2762-016-0 Benefit Details |
Johnson | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 608 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Bravo Liberty II Rx (PFFS) - H7406-001-0 Benefit Details |
Johnson | $71.00 | $0 | No Gap Coverage | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 36 members Browse Formulary | |||||
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Care N' Care Health Plan I (PPO) - H6328-001-0 Benefit Details |
Johnson | $75.00 | $0 | Many Generics | Preferred Generic: $0.00 Preferred Brand: $30.00 Non- Preferred Drugs: $60.00 Specialty: 33% | 529 members Browse Formulary | |||||
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HumanaChoice R5826-075 (Regional PPO) - R5826-075-0 Benefit Details |
Johnson | $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 | |||||
Any, Any, Any Platinum (PFFS) - H5820-013-0 Benefit Details |
Johnson | $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 | |||||
CIGNA Medicare Access Plus RX Plan Four (PFFS) - H2762-036-0 Benefit Details |
Johnson | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option II (PFFS) - H5006-017-1 Benefit Details |
Johnson | $99.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $34.00 Specialty: 25% | 8,639 members Browse Formulary | |||||
Today's Options Premier powered by CCRx (PFFS) - H5421-066-0 Benefit Details |
Johnson | $101.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 738 members Browse Formulary | |||||
Humana Gold Choice H2944-027 (PFFS) - H2944-027-0 Benefit Details |
Johnson | $104.00 | $0 | Few Generics, Few Brand | Preferred Generic: $7.00 Non-Preferred Generic/Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty: 33% | 404 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Sterling Option IV (PFFS) - H5006-016-1 Benefit Details |
Johnson | $119.00 | $225 | No Gap Coverage | Generic: $10.00 Brand: $36.00 Specialty: 25% | 3,337 members Browse Formulary | |||||
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