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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Humana Gold Choice H2944-185 (PFFS) - H2944-185-0 Benefit Details |
Jerome | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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SecureHorizons MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details |
Jerome | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,200 | ||||||
Secure Blue (PPO) - H1302-004-0 Benefit Details |
Jerome | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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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 | |||||||||
SecureHorizons MedicareDirect Rx (PFFS) - H5435-014-0 Benefit Details |
Jerome | $20.00 | $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: $88.00 Specialty Tier Drugs: 33% | $5,200 Browse Formulary | |||||
Today's Options Premier 800 (PFFS) - H5421-047-0 Sanctioned Plan |
Jerome | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
True Blue (HMO) - H1350-006-0 Benefit Details |
Jerome | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
Sterling Basic (PFFS) - H5006-018-8 Benefit Details |
Jerome | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
Secure Blue (PPO) - H1302-001-0 Benefit Details |
Jerome | $43.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $41.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
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Flexi Blue (PFFS) - H5862-001-0 Benefit Details |
Jerome | $54.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 25% | $3,000 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 | |||||||||
Today's Options Premier 850B powered by CCRx (PFFS) - H5421-065-0 Sanctioned Plan |
Jerome | $60.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic and Preferred Brand Drugs: $4.00 Non-Preferred Generic and Preferred Brand Drugs: $35.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 29% | $6,700 Browse Formulary | |||||
Sterling Option I (PFFS) - H5006-014-5 Benefit Details |
Jerome | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Humana Gold Choice H2944-189 (PFFS) - H2944-189-0 Benefit Details |
Jerome | $71.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 |
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Service | Exper. | Cost Info | |||||||||
Sterling Option II (PFFS) - H5006-017-8 Benefit Details |
Jerome | $90.70 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $18.00 Preferred Brand Drugs: $40.00 Specialty Tier Drugs: 25% | $4,000 Browse Formulary | |||||
True Blue Rx Option II (HMO) - H1350-010-0 Benefit Details |
Jerome | $116.00 | $260 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $41.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
True Blue Rx Option I (HMO) - H1350-001-0 Benefit Details |
Jerome | $135.00 | $0 | Many Generics | Preferred Generic Drugs: $6.00 Preferred Brand Drugs: $31.00 Non-Preferred Brand Drugs: $41.00 Specialty Tier Drugs: 25% | $3,000 Browse Formulary | |||||
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