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 |
|||||||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Monroe | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Paramount Elite - Standard Medical and Drug (HMO) - H3653-015-0 Benefit Details |
Monroe | $23.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Brand Drugs: $45.00 Injectable Drugs: 33% 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 |
|||||
Service | Exper. | Cost Info | |||||||||
BCN Advantage Option 1 (HMO-POS) - H5883-001-3 Benefit Details |
Monroe | $24.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,400 | ||||||
PriorityMedicare Value (HMO-POS) - H2320-012-0 Benefit Details |
Monroe | $56.40 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $9.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $81.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Monroe | $61.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Statewide | $61.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
BCN Advantage Option 2 (HMO-POS) - H5883-002-3 Benefit Details |
Monroe | $69.00 | $0 | Many Generics | Tier 1: tbd | $4,200 Browse Formulary | |||||
Paramount Elite - Enhanced Medical Only (HMO) - H3653-018-0 Benefit Details |
Monroe | $75.00 | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
PriorityMedicare (HMO-POS) - H2320-008-0 Benefit Details |
Monroe | $81.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-008-0 Benefit Details |
Monroe | $95.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Monroe | $105.00 | $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% | $4,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Statewide | $105.00 | $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% | $4,000 Browse Formulary | |||||
Paramount Elite - Enhanced Medical and Drug (HMO) - H3653-004-0 Benefit Details |
Monroe | $105.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $85.00 Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-007-0 Benefit Details |
Monroe | $113.00 | $110 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: 30% Specialty Tier Drugs: 30% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-4 Benefit Details |
Monroe | $129.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,000 Browse Formulary | |||||
-- | -- | ||||||||||
Alliance Medicare PPO (PPO) - H2322-001-0 Benefit Details |
Monroe | $150.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: 33% Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-010-0 Benefit Details |
Monroe | $158.00 | $0 | All Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $5.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 33% 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Alliance Medicare PPO (PPO) - H2322-004-0 Benefit Details |
Monroe | $183.00 | $0 | All Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: 33% Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
BCN Advantage Option 3 (HMO-POS) - H5883-003-3 Benefit Details |
Monroe | $193.00 | $0 | Many Generics | Tier 1: tbd | $4,000 Browse Formulary | |||||
|