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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Any, Any, Any Gold (PFFS) - H5820-011-0 Benefit Details |
Sharkey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Any, Any, Any Gold MA Only (PFFS) - H5820-029-0 Benefit Details |
Sharkey | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
e-Any, Any, Any Gold Direct (PFFS) - H5820-033-0 Benefit Details |
Sharkey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $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 | |||||||||
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 | ||||||
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
Sharkey | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Windsor Medicare Extra Emerald Plan (HMO) - H5698-061-0 Benefit Details |
Sharkey | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $12.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $68.00 Specialty Tier Drugs: 33% | $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 | |||||||||
Windsor Medicare Extra Silver Plan (HMO) - H5698-035-0 Benefit Details |
Sharkey | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Sterling Basic (PFFS) - H5006-018-4 Benefit Details |
Sharkey | $9.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
Sharkey | $19.00 | 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 |
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Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Gold Plan (HMO) - H5698-028-0 Benefit Details |
Sharkey | $25.00 | $0 | Some Generics | Preferred Generic Drugs: $3.00 Generic Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-4 Benefit Details |
Sharkey | $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 | |||||
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 R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
Sharkey | $40.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 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 | |||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
Sharkey | $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 | |||||
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 | |||||||||
Any, Any, Any Platinum (PFFS) - H5820-008-0 Benefit Details |
Sharkey | $65.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Generic Drugs: $3.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Today's Options Premier 800 (PFFS) - H5421-056-0 Sanctioned Plan |
Sharkey | $75.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Windsor Medicare Extra Diamond Plan (HMO) - H5698-067-0 Benefit Details |
Sharkey | $100.00 | $0 | Some Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | $3,400 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 | |||||||||
Today's Options Premier 850F powered by CCRx (PFFS) - H5421-074-0 Sanctioned Plan |
Sharkey | $106.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic and Preferred Brand Drugs: $4.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $80.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
Humana Gold Choice H1804-128 (PFFS) - H1804-128-0 Benefit Details |
Sharkey | $131.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Today's Options Premier 450A powered by CCRx (PFFS) - H5421-068-0 Sanctioned Plan |
Sharkey | $166.00 | $150 | Many Generics, Some Brands | Generic and Preferred Brand Drugs: $4.00 Non-Preferred Generic and Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 29% | $3,400 Browse Formulary | |||||
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