2011 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Rocky Mountain Green Plan (Cost) - H0602-042-0 Benefit Details |
Garfield | $7.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
AB Basic Plan (Cost) - H0602-026-0 Benefit Details |
Garfield | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
Rocky Mountain Green Plan + Rx (Cost) - H0602-043-0 Benefit Details |
Garfield | $39.20 | $115 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $2.00 Non-Preferred Generic and Brand Drugs: $9.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $63.00 Specialty Tier Drugs: 30% | $5,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Rocky Mountain Thrifty Plan (Cost) - H0602-027-0 Benefit Details |
Garfield | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
Rocky Mountain Standard Plan (Cost) - H0602-001-0 Benefit Details |
Garfield | $74.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
Rocky Mountain Thrifty Plan + Rx (Cost) - H0602-039-0 Benefit Details |
Garfield | $79.90 | $120 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $2.00 Non-Preferred Generic and Brand Drugs: $13.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $64.00 Specialty Tier Drugs: 30% | N/A Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Rocky Mountain Standard Plan + Rx (Cost) - H0602-017-0 Benefit Details |
Garfield | $116.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Non-Preferred Generic and Brand Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 33% | N/A Browse Formulary | |||||
Rocky Mountain Plus Plan (Cost) - H0602-003-0 Benefit Details |
Garfield | $160.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
Rocky Mountain Plus Plan + Rx (Cost) - H0602-019-0 Benefit Details |
Garfield | $246.20 | $0 | All Generics | Generic Drugs: $8.50 Non-Preferred Generic and Brand Drugs: $8.50 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $58.00 Specialty Tier Drugs: 33% | N/A Browse Formulary | |||||
|