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 |
|||||||||
AR Blue Cross - Medi-Pak Advantage MA (PFFS) - H4213-002-0 Benefit Details |
Ashley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | -- | ||||||||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R3444-009-0 Benefit Details |
Ashley | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R3444-009-0 Benefit Details |
Statewide | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H2944-197 (PFFS) - H2944-197-0 Benefit Details |
Ashley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
-- | -- | ||||||||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Ashley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
SecureHorizons MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details |
Ashley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,200 | ||||||
Windsor Medicare Extra Emerald Plan (HMO) - H5698-063-0 Benefit Details |
Ashley | $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 | |||||
Windsor Medicare Extra Silver Plan (HMO) - H5698-035-0 Benefit Details |
Ashley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Sterling Basic (PFFS) - H5006-018-4 Benefit Details |
Ashley | $9.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
Sterling Option I (PFFS) - H5006-014-1 Benefit Details |
Ashley | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
SecureHorizons MedicareDirect Rx (PFFS) - H5435-014-0 Benefit Details |
Ashley | $20.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $88.00 Specialty Tier Drugs: 33% | $5,200 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Fusion Plan (HMO SNP) - H5698-129-0 Benefit Details |
Ashley | $20.00 | $0 | Some Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Sterling Option II (PFFS) - H5006-017-4 Benefit Details |
Ashley | $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 | |||||
Care Improvement Plus Medicare Advantage (PPO) - H6528-001-0 Benefit Details |
Ashley | $32.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $95.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Comp Plus Plan (HMO SNP) - H5698-128-0 Benefit Details |
Ashley | $ 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 | |||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R3444-008-0 Benefit Details |
Ashley | $33.40 | $0 | 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% | n/a Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R3444-008-0 Benefit Details |
Statewide | $33.40 | $0 | 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% | 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 | |||||||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R3444-011-0 Benefit Details |
Ashley | $ 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: $10.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R3444-011-0 Benefit Details |
Statewide | $ 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: $10.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Gold Plan (HMO) - H5698-020-0 Benefit Details |
Ashley | $35.00 | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) - H4213-005-0 Benefit Details |
Ashley | $48.70 | $170 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $72.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
-- | -- | ||||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Ashley | $52.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Statewide | $52.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $95.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier 800 (PFFS) - H5421-049-0 Sanctioned Plan |
Ashley | $60.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Humana Gold Choice H2944-009 (PFFS) - H2944-009-0 Benefit Details |
Ashley | $62.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
-- | -- | ||||||||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Ashley | $69.00 | $310 | No additional gap coverage, only the Donut Hole Discount | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Statewide | $69.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Today's Options Premier 850E powered by CCRx (PFFS) - H5421-073-0 Sanctioned Plan |
Ashley | $80.00 | $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: $70.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
Windsor Medicare Extra Diabetes Plan (HMO SNP) - H5698-154-0 Benefit Details |
Ashley | $85.00 | $0 | Some Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier 450A powered by CCRx (PFFS) - H5421-067-0 Sanctioned Plan |
Ashley | $142.00 | $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 | |||||
Windsor Medicare Extra Diamond Plan (HMO) - H5698-069-0 Benefit Details |
Ashley | $160.00 | $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 | |||||
|