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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AARP MedicareComplete Plus (HMO-POS) - H7187-003-0 Benefit Details |
Salem City | $0.00 | $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: $85.00 Specialty Tier Drugs: 33% | $3,600 Browse Formulary | |||||
Carilion Clinic Medicare Health Plan Bronze (HMO) - H8050-005-0 Benefit Details |
Salem City | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $4.50 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 25% | $5,000 Browse Formulary | |||||
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Humana Gold Plus H2012-013 (HMO) - H2012-013-0 Benefit Details |
Salem City | $0.00 | $0 | Many Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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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 H2012-025 (HMO) - H2012-025-0 Benefit Details |
Salem City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Salem City | $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 |
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Service | Exper. | Cost Info | |||||||||
Southeast Community Care - Plus (HMO) - H5416-013-0 Sanctioned Plan |
Salem City | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 33% | $3,600 Browse Formulary | |||||
Today's Options Premier 600 (PFFS) - H6169-011-0 Sanctioned Plan |
Salem City | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
Humana Gold Choice H8145-044 (PFFS) - H8145-044-0 Benefit Details |
Salem City | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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 | |||||||||
Today's Options Premier 100 (PFFS) - H6169-001-0 Sanctioned Plan |
Salem City | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
new | new | new | |||||||||
Carilion Clinic Medicare Health Plan Silver (HMO-POS) - H8050-006-0 Benefit Details |
Salem City | $30.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | $3,200 Browse Formulary | |||||
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HumanaChoice H2542-004 (PPO) - H2542-004-0 Benefit Details |
Salem City | $31.00 | $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% | $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 | |||||||||
Today's Options Premier 650B powered by CCRx (PFFS) - H6169-031-0 Sanctioned Plan |
Salem City | $31.00 | $150 | No additional gap coverage, only the Donut Hole Discount | 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 | |||||
new | new | new | |||||||||
Humana Gold Choice H8145-041 (PFFS) - H8145-041-0 Benefit Details |
Salem City | $42.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
new | new | new | |||||||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Statewide | $58.00 | $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 R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Salem City | $58.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 Browse Formulary | |||||
Carilion Clinic Medicare Health Plan Gold (HMO-POS) - H8050-001-0 Benefit Details |
Salem City | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $3,200 Browse Formulary | |||||
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HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Salem City | $64.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $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 R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Statewide | $64.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,900 Browse Formulary | |||||
Today's Options Premier 150A powered by CCRx (PFFS) - H6169-021-0 Sanctioned Plan |
Salem City | $74.00 | $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% | $3,250 Browse Formulary | |||||
new | new | new | |||||||||
Carilion Clinic Medicare Health Plan Platinum (HMO-POS) - H8050-007-0 Benefit Details |
Salem City | $142.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | $3,200 Browse Formulary | |||||
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