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 Choice Essential (Regional PPO) - R5287-002-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
AARP MedicareComplete Choice Essential (Regional PPO) - R5287-002-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
AARP MedicareComplete Choice Plan 2 (Regional PPO) - R5287-001-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,750 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 | |||||||||
AARP MedicareComplete Choice Plan 2 (Regional PPO) - R5287-001-0 Benefit Details |
Statewide | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,750 Browse Formulary | |||||
Any, Any, Any Gold (PFFS) - H8098-001-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
new | new | new | |||||||||
Any, Any, Any Gold MA Only (PFFS) - H8098-003-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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 | |||||||||
e-Any, Any, Any Gold Direct (PFFS) - H8098-005-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
new | new | new | |||||||||
Freedom Medicare Plan Rx (HMO) - H5427-059-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $20.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Freedom Savings Plan (HMO) - H5427-052-0 Benefit Details |
Escambia | $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 | |||||||||
Freedom Savings Plan Rx (HMO) - H5427-053-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $25.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HealthyAdvantage (HMO) - H5410-004-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HealthyAdvantage Plus (HMO) - H5410-005-0 Benefit Details |
Escambia | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $12.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $70.00 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 | |||||||||
Humana Gold Plus H1036-143 (HMO) - H1036-143-0 Benefit Details |
Escambia | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: 0% Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Humana Gold Plus H1036-144 (HMO) - H1036-144-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
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 R5826-018 (Regional PPO) - R5826-018-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
Optimum Platinum Plan (HMO-POS) - H5594-006-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
WellCare Value (HMO) - H1032-079-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $3.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $79.00 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 | |||||||||
TotalCare (HMO SNP) - H5410-010-0 Benefit Details |
Escambia | $ 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) - H5417-001-0 Benefit Details |
Escambia | $25.40 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Evercare Plan RDP (Regional PPO SNP) - R5287-003-0 Benefit Details |
Escambia | $ 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 | |||||||||
Evercare Plan RDP (Regional PPO SNP) - R5287-003-0 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 | Tier 1: tbd | n/a Browse Formulary | |||||
WellCare Select (HMO-POS SNP) - H1032-101-0 Benefit Details |
Escambia | $ 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: $3.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $86.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-010 (PFFS) - H8145-010-0 Benefit Details |
Escambia | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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 | |||||||||
HealthyAdvantage Premier (HMO-POS) - H5410-012-0 Benefit Details |
Escambia | $35.50 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $12.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
WellCare Choice (HMO-POS) - H1032-025-0 Benefit Details |
Escambia | $39.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $3.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
HumanaChoice R5826-074 (Regional PPO) - R5826-074-0 Benefit Details |
Escambia | $50.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 R5826-074 (Regional PPO) - R5826-074-0 Benefit Details |
Statewide | $50.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $4,500 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) - R3332-001-0 Benefit Details |
Escambia | $63.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 25% | $4,500 Browse Formulary | |||||
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BlueMedicare Regional PPO (Regional PPO) - R3332-001-0 Benefit Details |
Statewide | $63.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 25% | $4,500 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 | |||||||||
Any, Any, Any Platinum (PFFS) - H8098-009-0 Benefit Details |
Escambia | $69.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: 0% Generic Drugs: $3.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $65.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
new | new | new | |||||||||
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0 Benefit Details |
Escambia | $80.00 | $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% | $6,000 Browse Formulary | |||||
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0 Benefit Details |
Statewide | $80.00 | $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% | $6,000 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 Choice H8145-061 (PFFS) - H8145-061-0 Benefit Details |
Escambia | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $6,300 Browse Formulary | |||||
new | new | new | |||||||||
BlueMedicare PPO (PPO) - H5434-002-0 Benefit Details |
Escambia | $150.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
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