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 Plus (HMO-POS) - H2182-001-0 Benefit Details |
Clayton | $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% | $3,380 Browse Formulary | |||||
Advantra Elite (HMO) - H5302-008-0 Benefit Details |
Clayton | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Advantra Silver (HMO-POS) - H5302-003-0 Benefit Details |
Clayton | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $76.00 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 | |||||||||
Any, Any, Any Gold (PFFS) - H8098-001-0 Benefit Details |
Clayton | $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 |
Clayton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
new | new | new | |||||||||
BlueValue Basic (HMO) - H5422-006-0 Benefit Details |
Clayton | $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 | $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 | |||||||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R9896-009-0 Benefit Details |
Clayton | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R9896-009-0 Benefit Details |
Statewide | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
e-Any, Any, Any Gold Direct (PFFS) - H8098-005-0 Benefit Details |
Clayton | $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 | |||||||||
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 R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Clayton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Kaiser Permanente Senior Advantage Basic (HMO) - H1170-009-0 Benefit Details |
Clayton | $0.00 | $0 | All Generics | Tier 1: tbd | $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 | |||||||||
WellCare Advance (HMO) - H1112-003-0 Benefit Details |
Clayton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,150 | ||||||
WellCare Value (HMO-POS) - H1112-027-0 Benefit Details |
Clayton | $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: $75.00 Specialty Tier Drugs: 33% | $4,000 Browse Formulary | |||||
Senior Advantage Medicare Medicaid Plan (HMO SNP) - H1170-008-0 Benefit Details |
Clayton | $ 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 | |||||||||
Humana Gold Choice H8145-117 (PFFS) - H8145-117-0 Benefit Details |
Clayton | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
new | new | new | |||||||||
Evercare Plan DP (PPO SNP) - H1108-002-0 Benefit Details |
Clayton | $ 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 | |||||
BlueValue Secure (HMO) - H5422-002-0 Benefit Details |
Clayton | $22.00 | $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 | |||||||||
Silver Advantage (HMO) - H5302-007-0 Benefit Details |
Clayton | $25.40 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Evercare Plan IP (PPO SNP) - H1108-001-0 Benefit Details |
Clayton | $30.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (PPO) - H6528-006-0 Benefit Details |
Clayton | $32.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R9896-008-0 Benefit Details |
Clayton | $34.90 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R9896-008-0 Benefit Details |
Statewide | $34.90 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Advantra Silver Plus (HMO-POS) - H5302-006-0 Benefit Details |
Clayton | $38.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 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 | |||||||||
HumanaChoice H5214-003 (PPO) - H5214-003-0 Benefit Details |
Clayton | $42.00 | $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% | $4,900 Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
Clayton | $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% | $5,900 Browse Formulary | |||||
HumanaChoice R5826-004 (Regional PPO) - R5826-004-0 Benefit Details |
Statewide | $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% | $5,900 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 | |||||||||
Kaiser Permanente Senior Advantage Enhanced (HMO) - H1170-002-0 Benefit Details |
Clayton | $61.00 | $0 | All Generics | Tier 1: tbd | $3,400 Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Clayton | $63.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Statewide | $63.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $95.00 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 | |||||||||
Any, Any, Any Platinum (PFFS) - H8098-009-0 Benefit Details |
Clayton | $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 R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Clayton | $69.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 29% | $5,900 Browse Formulary | |||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Statewide | $69.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 29% | $5,900 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-079 (PFFS) - H8145-079-0 Benefit Details |
Clayton | $70.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $41.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,900 Browse Formulary | |||||
new | new | new |
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