2011 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) Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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Arcadian Community Care - Plus (HMO) - H7179-012-0 Sanctioned Plan |
Livingston | $0.00 | $0 | Many Generics | Preferred Generic Drugs: 0% Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 33% | $4,950 Browse Formulary | |||||
Humana Gold Plus H1951-005 (HMO) - H1951-005-0 Benefit Details |
Livingston | $0.00 | $0 | Many Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $50.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Humana Gold Plus H1951-030 (HMO) - H1951-030-0 Benefit Details |
Livingston | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
Livingston | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Peoples Health Choices Plus (HMO-POS) - H1961-002-0 Benefit Details |
Livingston | $0.00 | $0 | All Generics | Tier 1: tbd | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
WellCare Advance (HMO) - H1903-005-0 Benefit Details |
Livingston | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,350 | ||||||
WellCare Dividend (HMO-POS) - H1903-024-0 Benefit Details |
Livingston | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $4.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $6,000 Browse Formulary | |||||
WellCare Value (HMO-POS) - H1903-022-0 Benefit Details |
Livingston | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $3.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 33% | $4,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Sterling Connect Basic (PFFS) - H3410-001-1 Benefit Details |
Livingston | $9.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
new | new | new | |||||||||
Sterling Connect 1 (PFFS) - H3410-002-1 Benefit Details |
Livingston | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
new | new | new | |||||||||
Sterling Connect 2 (PFFS) - H3410-003-1 Benefit Details |
Livingston | $30.70 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $18.00 Preferred Brand Drugs: $40.00 Specialty Tier Drugs: 25% | $4,000 Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
WellCare Access (HMO SNP) - H1903-011-0 Benefit Details |
Livingston | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 0% Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Arcadian Community Care - Dual Plus (HMO SNP) - H7179-013-0 Sanctioned Plan |
Livingston | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Peoples Health Secure Health (HMO SNP) - H1961-003-0 Benefit Details |
Livingston | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 25% Preferred Brand Drugs: 25% Non-Preferred Brand Drugs: 25% Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Plus SNP-DE H1951-019 (HMO SNP) - H1951-019-0 Benefit Details |
Livingston | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
Livingston | $40.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 Browse Formulary | |||||
HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
Statewide | $40.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
Livingston | $62.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,500 Browse Formulary | |||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
Statewide | $62.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,500 Browse Formulary | |||||
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