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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Horizon Medicare Blue Value (HMO) - H3154-013-0 Benefit Details |
Cumberland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Horizon Medicare Blue Value w/ Rx Std (HMO) - H3154-004-0 Benefit Details |
Cumberland | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
Aetna Medicare Standard Plan (HMO) - H3152-022-0 Sanctioned Plan |
Cumberland | $23.50 | $0 | n/a | Tier 1: Preferred Generic Drugs: $6.00 Tier 2: Non-Preferred Generic Drugs: $34.00 Tier 3: Preferred Brand Drugs: $45.00 Tier 4: Non-Preferred Brand Drugs: $85.00 Tier 5: Specialty Tier Drugs: 33% | 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 | |||||||||
Horizon Medicare Blue Access (HMO-POS) - H3154-005-0 Benefit Details |
Cumberland | $49.50 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Horizon Medicare Blue Value w/ Rx Enhanced (HMO) - H3154-016-0 Benefit Details |
Cumberland | $56.10 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $76.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Horizon Medicare Blue Access w/ Rx Std (HMO-POS) - H3154-012-0 Benefit Details |
Cumberland | $108.60 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $11.00 Preferred Brand Drugs: $47.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25% | $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 | |||||||||
Horizon Medicare Blue Access w/Rx Enhanced (HMO-POS) - H3154-006-0 Benefit Details |
Cumberland | $136.80 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $37.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
AmeriHealth 65 NJ Medical Only (HMO) - H3156-027-0 Benefit Details |
Cumberland | $160.70 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
AmeriHealth 65 NJ Rx (HMO) - H3156-028-0 Benefit Details |
Cumberland | $216.10 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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