2011 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) 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 |
|||||||||
UCare Connect (HMO SNP) - H2459-016-0 Benefit Details |
Le Sueur | $ 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 | |||||
Platinum Blue Core Plan (Cost) - H2461-005-0 Benefit Details |
Le Sueur | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
SecureBlue (HMO SNP) - H2425-001-0 Benefit Details |
Le Sueur | $ 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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
UCare's Minnesota Senior Health Options (HMO SNP) - H2456-002-0 Benefit Details |
Le Sueur | $ 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 | |||||
UCare for Seniors Value (HMO-POS) - H2459-001-0 Benefit Details |
Le Sueur | $41.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice H6609-028 (PPO) - H6609-028-0 Benefit Details |
Le Sueur | $45.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 29% | $6,700 Browse Formulary | |||||
-- | -- | ||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H6609-021 (PPO) - H6609-021-0 Benefit Details |
Le Sueur | $55.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
-- | -- | ||||||||||
UCare for Seniors Standard D (HMO-POS) - H2459-018-0 Benefit Details |
Le Sueur | $58.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
HealthPartners Freedom Plan I (Cost) - H2462-004-0 Benefit Details |
Le Sueur | $61.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Value Thrift with Rx (Cost) - H2450-007-0 Benefit Details |
Le Sueur | $61.50 | $185 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $5,000 Browse Formulary | |||||
Humana Gold Choice H8145-089 (PFFS) - H8145-089-0 Benefit Details |
Le Sueur | $69.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
new | new | new | |||||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Le Sueur | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Statewide | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
Platinum Blue Choice Plan (Cost) - H2461-006-0 Benefit Details |
Le Sueur | $79.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
UCare for Seniors Value Plus (HMO-POS) - H2459-013-0 Benefit Details |
Le Sueur | $79.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Value Plus w/Thrift Rx - MN (Cost) - H2450-022-0 Benefit Details |
Le Sueur | $89.50 | $180 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $10.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
HealthPartners Freedom Plan II (Cost) - H2462-007-0 Benefit Details |
Le Sueur | $93.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Medica Prime Solution Value Plus with Std Rx - MN (Cost) - H2450-023-0 Benefit Details |
Le Sueur | $98.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) - H2462-008-0 Benefit Details |
Le Sueur | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Platinum Blue Complete Plan (Cost) - H2461-007-0 Benefit Details |
Le Sueur | $109.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Medica Prime Solution Basic with Thrift Rx - MN (Cost) - H2450-016-0 Benefit Details |
Le Sueur | $113.50 | $180 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $10.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic with Standard Rx - MN (Cost) - H2450-001-0 Benefit Details |
Le Sueur | $122.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
UCare for Seniors Classic (HMO-POS) - H2459-002-0 Benefit Details |
Le Sueur | $129.00 | $0 | Many Generics | Generic Drugs: $9.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $3,400 Browse Formulary | |||||
HealthPartners Freedom Plan III (Cost) - H2462-010-0 Benefit Details |
Le Sueur | $134.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan III StandardRx (Cost) - H2462-011-0 Benefit Details |
Le Sueur | $158.90 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Medica Prime Solution Enhanced with Thrift Rx - MN (Cost) - H2450-017-0 Benefit Details |
Le Sueur | $161.50 | $180 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $10.00 Non-Preferred Generic and Preferred Brand Drugs: $34.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
Medica Prime Solution Enhanced w/Standard Rx - MN (Cost) - H2450-002-0 Benefit Details |
Le Sueur | $170.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) - H2450-005-0 Benefit Details |
Le Sueur | $175.20 | $0 | Many Generics | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
Medica Prime Solution Enhanced w/Enhanced Rx- MN (Cost) - H2450-006-0 Benefit Details |
Le Sueur | $223.30 | $0 | Many Generics | Generic Drugs: $10.00 Preferred Brand Drugs: $34.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan III EnhancedRx (Cost) - H2462-012-0 Benefit Details |
Le Sueur | $333.80 | $100 | Many Generics, Some Brands | Generic Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
|