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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HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Bullock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
VIVA Medicare Plus Rx (HMO) - H0154-001-0 Benefit Details |
Bullock | $0.00 | $130 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 28% | $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 | |||||||||
VIVA Medicare Plus Select (HMO) - H0154-008-0 Benefit Details |
Bullock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
HumanaChoice H1681-005 (PPO) - H1681-005-0 Benefit Details |
Bullock | $34.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $4,900 Browse Formulary | |||||
HumanaChoice R5826-001 (Regional PPO) - R5826-001-0 Benefit Details |
Bullock | $59.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,900 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 R5826-001 (Regional PPO) - R5826-001-0 Benefit Details |
Statewide | $59.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,900 Browse Formulary | |||||
VIVA Medicare Plus Rx Premier (HMO) - H0154-011-0 Benefit Details |
Bullock | $97.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Blue Advantage Complete (PPO) - H0104-011-3 Benefit Details |
Bullock | $99.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Generic and Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 30% | $3,400 Browse Formulary | |||||
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