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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AR Blue Cross - Medi-Pak Advantage MA (PFFS) - H4213-001-0 Benefit Details |
Logan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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AR Blue Cross - Medi-Pak Advantage MA-PD Option 1 (PFFS) - H4213-004-0 Benefit Details |
Logan | $0.00 | $180 | 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% | $5,750 Browse Formulary | |||||
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Arkansas Community Care - Plus (HMO) - H5700-009-0 Benefit Details |
Logan | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 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 | |||||||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R3444-009-0 Benefit Details |
Logan | $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 | |||||
Humana Gold Choice H8145-120 (PFFS) - H8145-120-0 Benefit Details |
Logan | $0.00 | 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 | |||||||||
Humana Gold Plus H2012-001 (HMO) - H2012-001-0 Benefit Details |
Logan | $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: $75.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Logan | $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 |
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Service | Exper. | Cost Info | |||||||||
Mercy MedicareADVANTAGE AR (PPO) - H2611-008-0 Benefit Details |
Logan | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $70.00 Specialty Tier Drugs: 33% | $4,800 Browse Formulary | |||||
Windsor Medicare Extra Emerald Plan (HMO) - H5698-063-0 Benefit Details |
Logan | $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 |
Logan | $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 | |||||||||
Windsor Medicare Extra Fusion Plan (HMO SNP) - H5698-129-0 Benefit Details |
Logan | $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 | |||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 2 (PFFS) - H4213-007-0 Benefit Details |
Logan | $26.90 | $0 | 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% | $4,750 Browse Formulary | |||||
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Arkansas Community Care -Dual Plus (HMO SNP) - H5700-018-0 Benefit Details |
Logan | $ 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 | |||||
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 Comp Plus Plan (HMO SNP) - H5698-128-0 Benefit Details |
Logan | $ 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 |
Logan | $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 |
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Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R3444-011-0 Benefit Details |
Logan | $ 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 |
Logan | $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 |
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Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Logan | $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 | |||||
Humana Gold Choice H8145-122 (PFFS) - H8145-122-0 Benefit Details |
Logan | $57.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
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 | |||||||||
HumanaChoice H7188-003 (PPO) - H7188-003-0 Benefit Details |
Logan | $66.00 | $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% | $4,000 Browse Formulary | |||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Logan | $69.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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 | |||||
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 Diabetes Plan (HMO SNP) - H5698-154-0 Benefit Details |
Logan | $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 | |||||
Windsor Medicare Extra Diamond Plan (HMO) - H5698-069-0 Benefit Details |
Logan | $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 | |||||
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