$dynamicTitle=$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 |
|||||||||
AARP MedicareComplete Plus (HMO-POS) - H5253-004-0 Benefit Details |
Ozaukee | $0.00 | $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: $79.00 Tier 4 Specialty: 33% | 26,772 members Browse Formulary | |||||
AARP MedicareComplete Plus Essential (HMO-POS) - H5253-021-0 Benefit Details |
Ozaukee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Ozaukee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 9,018 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 9,018 members | ||||||
SecureHorizons MedicareDirect Plan 3 (PFFS) - H5435-003-0 Benefit Details |
Ozaukee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 24,942 members | ||||||
Today's Health Value (HMO) - H8742-003-0 Benefit Details |
Ozaukee | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 469 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Today's Health Classic powered by CCRx (HMO) - H8742-001-0 Benefit Details |
Ozaukee | $19.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
SmartValue Classic (PFFS) - H0540-090-0 Benefit Details |
Ozaukee | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 11,362 members | ||||||
Evercare Plan MH-POS (HMO-POS) - H5253-027-0 Benefit Details |
Ozaukee | $25.00 | $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% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Plan 100 (PFFS) - H5435-020-0 Benefit Details |
Ozaukee | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 4,121 members | ||||||
Evercare Plan DH (HMO) - H5253-024-0 Benefit Details |
Ozaukee | $ 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 | |||||
Today's Options Value (PFFS) - H5421-113-0 Benefit Details |
Ozaukee | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 65 members | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
Managed Health Services (HMO) - H8189-001-0 Benefit Details |
Ozaukee | $ 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: $34.00 Non-Preferred Brand: $88.00 Injectables: $88.00 | < 10 members Browse Formulary | |||||
-- | |||||||||||
Evercare Plan IH-POS (HMO-POS) - H5253-007-0 Benefit Details |
Ozaukee | $38.20 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | 703 members Browse Formulary | |||||
iCare Medicare Plan (HMO) - H2237-001-0 Benefit Details |
Ozaukee | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No Gap Coverage | Generic: $4.00 Other: $47.00 | 3,612 members Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
Plan ID Members | |||||
Service | Exper. | Cost Info | |||||||||
SmartValue Plus (PFFS) - H0540-091-0 Benefit Details |
Ozaukee | $40.00 | $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% | 12,629 members Browse Formulary | |||||
Today's Options Advantage 2 powered by CCRx (PPO) - H5378-154-0 Benefit Details |
Ozaukee | $41.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 568 members Browse Formulary | |||||
new | new | new | |||||||||
Today's Options Value powered by CCRx (PFFS) - H5421-116-0 Benefit Details |
Ozaukee | $51.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 198 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 Health Premier powered by CCRx (HMO) - H8742-008-0 Benefit Details |
Ozaukee | $59.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 775 members Browse Formulary | |||||
Humana Gold Choice H2944-065 (PFFS) - H2944-065-0 Benefit Details |
Ozaukee | $61.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 9,894 members Browse Formulary | |||||
Today's Options Premier (PFFS) - H5421-112-0 Benefit Details |
Ozaukee | $69.70 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | 159 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 1 powered by CCRx (PPO) - H5378-061-0 Benefit Details |
Ozaukee | $70.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 40 members Browse Formulary | |||||
new | new | new | |||||||||
HumanaChoice H5216-001 (PPO) - H5216-001-0 Benefit Details |
Ozaukee | $91.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | n/a Browse Formulary | |||||
-- | |||||||||||
Today's Options Advantage 3 powered by CCRx (PPO) - H5378-092-0 Benefit Details |
Ozaukee | $97.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 48 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 | |||||||||
Today's Options Premier powered by CCRx (PFFS) - H5421-115-0 Benefit Details |
Ozaukee | $107.00 | $0 | All Generics | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 108 members Browse Formulary | |||||
Humana Gold Choice H2944-066 (PFFS) - H2944-066-0 Benefit Details |
Ozaukee | $163.00 | $0 | Few Generics, Few Brand | Preferred Generic: $8.00 Non-Preferred Generic/Preferred Brand: $42.00 Non-Preferred Brand: $80.00 Specialty: 33% | 562 members Browse Formulary | |||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Ozaukee | $179.00 | $310 | 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 | |||||||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Statewide | $179.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
|