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 Essential (HMO) - H0543-121-0 Benefit Details |
Riverside | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
AARP MedicareComplete Plan 1 (HMO) - H0543-007-0 Benefit Details |
Riverside | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $88.00 Specialty Tier Drugs: 33% | $5,900 Browse Formulary | |||||
AARP MedicareComplete Plan 2 (HMO) - H0543-144-0 Benefit Details |
Riverside | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $3.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $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 | |||||||||
Aetna Medicare Select Plan (HMO) - H0523-022-0 Sanctioned Plan |
Riverside | $0.00 | $0 | n/a | Tier 1: Preferred Generic Drugs: $8.00 Tier 2: Non-Preferred Generic Drugs: $34.00 Tier 3: Preferred Brand Drugs: $40.00 Tier 4: Non-Preferred Brand Drugs: $85.00 Tier 5: Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
ARTA Medicare Health Plan (HMO) - H5948-001-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Brand Drugs: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Blue Cross Senior Secure Plan I (HMO) - H0564-047-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $7.00 | $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 | |||||||||
Blue Shield 65 Plus (HMO) - H0504-026-0 Benefit Details |
Riverside | $0.00 | $200 | Many Generics | Tier 1: tbd | $6,700 Browse Formulary | |||||
Care1st Medicare Advantage Value Plan (HMO) - H5928-012-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: 0% Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $50.00 Specialty Tier Drugs: 30% | $3,400 Browse Formulary | |||||
CareMore Diabetes (HMO SNP) - H0544-035-0 Benefit Details |
Riverside | $0.00 | $0 | All Generics | Preferred Generic Drugs: 0% Generic Drugs: $5.00 Brand Drugs: 0% Preferred Brand Drugs: $29.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 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 | |||||||||
CareMore Value Plus (HMO) - H0544-034-0 Benefit Details |
Riverside | $0.00 | $0 | All Generics | Preferred Generic Drugs: 0% Generic Drugs: $5.00 Brand Drugs: $25.00 Preferred Brand Drugs: $29.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Citizens Choice Healthplan (HMO) - H3815-005-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Generic Drugs: 0% Preferred Brand Drugs: $15.00 Non-Preferred Brand Drugs: $50.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Riverside | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,300 | ||||||
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 | |||||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Riverside (Partial) | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,300 | ||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,300 | ||||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $7.00 | $3,300 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 | |||||||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Riverside (Partial) | $0.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $7.00 | $3,300 Browse Formulary | |||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Statewide | $0.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $7.00 | $3,300 Browse Formulary | |||||
Health Net Healthy Heart Plan 1 (HMO) - H0562-082-0 Sanctioned Plan |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 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 | |||||||||
Health Net Seniority Plus Amber CHF (HMO SNP) - H0562-081-0 Sanctioned Plan |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-044-0 Sanctioned Plan |
Riverside | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Health Net Seniority Plus Ruby Plan 1 (HMO) - H0562-083-0 Sanctioned Plan |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 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 H0108-005 (HMO) - H0108-005-0 Benefit Details |
Riverside | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Inter Valley Health Plan Desert Preferred Choice (HMO) - H0545-012-0 Benefit Details |
Riverside | $0.00 | $0 | All Generics and Some Brands | Preferred Generic Drugs: 0% Non-Preferred Generic Drugs: $3.00 Preferred Brand Drugs: $25.00 Non-Preferred Brand Drugs: $40.00 Injectable Drugs: 15% Specialty Tier Drugs: 30% | $6,700 Browse Formulary | |||||
Inter Valley Health Plan Focus SNP (HMO SNP) - H0545-009-0 Benefit Details |
Riverside | $0.00 | $0 | Some Generics, Few Brands | Preferred Generic Drugs: $4.00 Non-Preferred Generic Drugs: $8.00 Brand Drugs: $18.00 Preferred Brand Drugs: $29.00 Non-Preferred Brand Drugs: $55.00 Specialty Tier Drugs: 25% | 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 | |||||||||
Inter Valley Health Plan Service To Seniors (HMO) - H0545-001-0 Benefit Details |
Riverside | $0.00 | $0 | Some Generics | Preferred Generic Drugs: $3.00 Non-Preferred Generic Drugs: $12.00 Preferred Brand Drugs: $29.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
Inter Valley Health Plan Total Fit (HMO) - H0545-011-0 Benefit Details |
Riverside | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $8.00 Non-Preferred Generic Drugs: $12.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Kaiser Permanente Senior Advantage Inland Empire (HMO) - H0524-015-0 Benefit Details |
Riverside | $0.00 | $0 | All Generics | Generic Drugs: $10.00 Brand Drugs: $45.00 Specialty Tier Drugs: 25% | $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 | |||||||||
MD Care Advantage 1 MAPD (HMO) - H7731-001-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Generic Drugs: 0% Preferred Brand Drugs: $19.00 Brand Drugs: $59.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
MD Care Advantage Select MA (HMO) - H7731-007-0 Benefit Details |
Riverside | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Salud con Health Net Medicare Advantage (HMO) - H0562-085-0 Sanctioned Plan |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 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 | |||||||||
SCAN Classic (HMO) - H5425-008-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $40.00 Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
SCAN Healthy at Home (HMO SNP) - H9104-008-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $37.00 Brand Drugs: $65.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
SCAN Options (HMO) - H5425-015-0 Benefit Details |
Riverside | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Brand Drugs: $75.00 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 | |||||||||
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) - H0524-029-0 Benefit Details |
Riverside | $ 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: $12.00 Brand Drugs: $44.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Evercare Plan DH (HMO SNP) - H0543-081-0 Benefit Details |
Riverside | $ 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 | |||||
Aetna Medicare Premier Plan (HMO) - H0523-056-0 Sanctioned Plan |
Riverside | $21.70 | $0 | n/a | Tier 1: Preferred Generic Drugs: $5.00 Tier 2: Non-Preferred Generic Drugs: $35.00 Tier 3: Preferred Brand Drugs: $45.00 Tier 4: Non-Preferred Brand Drugs: $85.00 Tier 5: 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 | |||||||||
Molina Medicare Options (HMO) - H5810-002-0 Benefit Details |
Riverside | $24.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $20.00 Non-Preferred Brand Drugs: $50.00 Specialty Tier Drugs: 33% | $3,350 Browse Formulary | |||||
Molina Medicare Options Plus (HMO SNP) - H5810-001-0 Benefit Details |
Riverside | $ 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: 0% Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Health Net Seniority Plus Amber I (HMO SNP) - H0562-055-0 Sanctioned Plan |
Riverside | $ 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 Seniority Plus Amber II (HMO SNP) - H0562-070-0 Sanctioned Plan |
Riverside | $ 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 | |||||
Arta Medicare Health Plan (HMO SNP) - H5948-002-0 Benefit Details |
Riverside | $ 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 | |||||
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IEHP Medicare DualChoice (HMO SNP) - H5640-001-0 Benefit Details |
Riverside | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | All Generics | Generic Drugs: 0% Preferred Brand Drugs: 25% | 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 | |||||||||
SCAN Connections (HMO SNP) - H5425-011-0 Benefit Details |
Riverside | $ 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: 0% Generic Drugs: 0% Preferred Brand Drugs: $45.00 Brand Drugs: $95.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Brand New Day (HMO SNP) - H0838-020-0 Benefit Details |
Riverside | $33.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Health Net Healthy Heart Plan 2 (HMO) - H0562-071-0 Sanctioned Plan |
Riverside | $39.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 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 | |||||||||
My Choice (HMO-POS) - H5425-027-0 Benefit Details |
Riverside | $40.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $37.00 Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $1,050 Browse Formulary | |||||
Humana Gold Plus H0108-006 (HMO-POS) - H0108-006-0 Benefit Details |
Riverside | $51.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
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VillageHealth (HMO-POS SNP) - H5943-001-0 Benefit Details |
Riverside | $113.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Generic Drugs: $6.00 Preferred Brand Drugs: $30.00 Brand Drugs: $55.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
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