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) - H3887-003-0 Benefit Details |
Cook | $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% | $3,800 Browse Formulary | |||||
Aetna Medicare Value Plan (HMO) - H1419-001-0 Sanctioned Plan |
Cook | $0.00 | $0 | n/a | Tier 1: Preferred Generic Drugs: $9.00 Tier 2: Non-Preferred Generic Drugs: $38.00 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 | |||||
HealthyAdvantage (HMO) - H1415-013-0 Benefit Details |
Cook | $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 | |||||||||
HealthyAdvantage Preferred (HMO-POS) - H1415-021-0 Benefit Details |
Cook | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Humana Gold Plus H1406-013 (HMO) - H1406-013-0 Benefit Details |
Cook | $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 | |||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Cook | $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 | |||||||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
WellCare Dividend (HMO) - H1416-022-0 Benefit Details |
Cook | $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% | $6,700 Browse Formulary | |||||
WellCare Value (HMO-POS) - H1416-009-0 Benefit Details |
Cook | $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: $69.00 Specialty Tier Drugs: 33% | $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 | |||||||||
WellCare Access (HMO SNP) - H1416-007-0 Benefit Details |
Cook | $ 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: $45.00 Non-Preferred Brand Drugs: $88.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
Evercare Plan DH-POS (HMO-POS SNP) - H3887-002-0 Benefit Details |
Cook | $ 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 Standard Plan (PPO) - H5521-016-0 Sanctioned Plan |
Cook | $24.10 | $0 | n/a | Tier 1: Preferred Generic Drugs: $8.00 Tier 2: Non-Preferred Generic Drugs: $38.00 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 | |||||
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) - H1415-005-0 Benefit Details |
Cook | $ 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 Rx (HMO) - H1416-019-0 Benefit Details |
Cook | $28.70 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $3.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Evercare Plan IH-POS (HMO-POS SNP) - H3887-001-0 Benefit Details |
Cook | $30.70 | $310 | 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 H8145-121 (PFFS) - H8145-121-0 Benefit Details |
Cook | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Cook | $61.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,000 Browse Formulary | |||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Statewide | $61.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 | |||||||||
HumanaChoice H1418-002 (PPO) - H1418-002-0 Benefit Details |
Cook | $101.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
Humana Gold Choice H8145-008 (PFFS) - H8145-008-0 Benefit Details |
Cook | $121.00 | $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% | $3,400 Browse Formulary | |||||
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