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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Desert Canyon Community Care-Plus (HMO) - H0320-005-0 Sanctioned Plan |
Mohave | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $7.50 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 33% | $4,950 Browse Formulary | |||||
HumanaChoice R5826-070 (Regional PPO) - R5826-070-0 Benefit Details |
Mohave | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
HumanaChoice R5826-070 (Regional PPO) - R5826-070-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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 | |||||||||
UnitedHealthcare Dual Complete (HMO SNP) - H0321-002-0 Benefit Details |
Mohave | $ 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 | |||||
Health Choice Generations (HMO SNP) - H5587-002-0 Benefit Details |
Mohave | $ 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 | |||||
HumanaChoice H0317-007 (PPO) - H0317-007-0 Benefit Details |
Mohave | $29.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $79.00 Specialty Tier Drugs: 33% | $4,500 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 R5826-014 (Regional PPO) - R5826-014-0 Benefit Details |
Mohave | $91.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
HumanaChoice R5826-014 (Regional PPO) - R5826-014-0 Benefit Details |
Statewide | $91.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Humana Gold Choice H8145-103 (PFFS) - H8145-103-0 Benefit Details |
Mohave | $139.00 | $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% | $6,700 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 | |||||||||
HumanaChoice R5826-076 (Regional PPO) - R5826-076-0 Benefit Details |
Mohave | $150.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,000 Browse Formulary | |||||
HumanaChoice R5826-076 (Regional PPO) - R5826-076-0 Benefit Details |
Statewide | $150.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,000 Browse Formulary | |||||
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