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 (HMO) - H0303-015-0 Benefit Details |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $44.00 Non-Preferred Generic and Non-Preferred Brand Drug: $88.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
AARP MedicareComplete Plus (HMO-POS) - H0316-002-0 Benefit Details |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,200 Browse Formulary | |||||
CIGNA Medicare Select Plus Rx (HMO) - H0354-001-0 Benefit Details |
Pinal | $0.00 | $0 | Many Generics | Generic and Preferred Brand Drugs: $5.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 25% | $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 | |||||||||
Health Net Green (HMO) - H0351-030-0 Sanctioned Plan |
Pinal | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Health Net Ruby 4 (HMO) - H0351-036-0 Sanctioned Plan |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $41.00 Non-Preferred Generic and Non-Preferred Brand Drug: $82.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $5,200 Browse Formulary | |||||
Humana Gold Plus H0307-009 (HMO-POS) - H0307-009-0 Benefit Details |
Pinal (Partial) | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 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 | |||||||||
Humana Gold Plus H0307-011 (HMO) - H0307-011-0 Benefit Details |
Pinal | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
HumanaChoice R5826-070 (Regional PPO) - R5826-070-0 Benefit Details |
Pinal | $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 |
Pinal (Partial) | $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 | |||||||||
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 | ||||||
MediSunONE Classic (HMO) - H0302-006-0 Benefit Details |
Pinal | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
MediSunONE Plus (HMO) - H0302-001-0 Benefit Details |
Pinal | $14.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 30% | $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 | |||||||||
UnitedHealthcare Dual Complete (HMO SNP) - H0321-002-0 Benefit Details |
Pinal | $ 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 | |||||
CIGNA Medicare Select Plus Rx-Dual (HMO SNP) - H0354-012-0 Benefit Details |
Pinal | $ 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 | |||||
Evercare Plan IP (PPO SNP) - H0319-001-0 Benefit Details |
Pinal | $24.60 | $310 | 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 | |||||||||
Abrazo Advantage (HMO) - H5985-001-0 Benefit Details |
Pinal | $25.00 | $0 | Many Generics | Generic Drugs: $10.00 Brand Drugs: $40.00 Specialty Tier Drugs: 20% | $6,700 Browse Formulary | |||||
Evercare Plan DH (HMO SNP) - H0303-034-0 Benefit Details |
Pinal (Partial) | $ 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 | |||||
Abrazo Advantage Plus (HMO SNP) - H5985-002-0 Benefit Details |
Pinal | $ 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 | |||||||||
Health Net Amber (HMO SNP) - H0351-029-0 Sanctioned Plan |
Pinal | $ 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 | Preferred Generic Drugs: $2.00 Preferred Brand Drugs: $38.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Injectable Drugs: 25% Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Health Choice Generations (HMO SNP) - H5587-001-0 Benefit Details |
Pinal | $ 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 Net Ruby 1 (HMO) - H0351-014-0 Sanctioned Plan |
Pinal | $33.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% 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 | |||||||||
Humana Gold Plus H0307-008 (HMO) - H0307-008-0 Benefit Details |
Pinal | $35.00 | $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 | |||||
Health Net Jade (HMO SNP) - H0351-038-0 Sanctioned Plan |
Pinal | $39.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $44.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
MediSunONE Premier (HMO) - H0302-007-0 Benefit Details |
Pinal | $45.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $28.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 30% | $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 | |||||||||
HumanaChoice H0317-004 (PPO) - H0317-004-0 Benefit Details |
Pinal | $53.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $82.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Humana Gold Plus H0307-010 (HMO-POS) - H0307-010-0 Benefit Details |
Pinal | $59.00 | $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 | |||||
HumanaChoice R5826-014 (Regional PPO) - R5826-014-0 Benefit Details |
Pinal | $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 | |||||
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 |
Pinal (Partial) | $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 |
Pinal | $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 | |||||
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 R5826-076 (Regional PPO) - R5826-076-0 Benefit Details |
Pinal | $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 |
Pinal (Partial) | $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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