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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BCN Advantage Basic (HMO-POS) - H5883-004-5 Benefit Details |
Oakland | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,000 Browse Formulary | |||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Oakland | $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 | ||||||
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 | |||||||||
BCN Advantage Option 1 (HMO-POS) - H5883-001-5 Benefit Details |
Oakland | $24.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,400 | ||||||
Erickson Advantage Guardian (HMO-POS SNP) - H5652-003-0 Benefit Details |
Oakland | $29.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
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UnitedHealthcare Dual Complete (HMO SNP) - H6952-002-0 Benefit Details |
Oakland | $ 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 | |||||
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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 | |||||||||
Fidelis Secure Comfort (HMO SNP) - H2323-005-0 Benefit Details |
Oakland | $34.70 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
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Midwest Advantage (HMO SNP) - H5685-001-0 Benefit Details |
Oakland | $ 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: 0% Brand Drugs: 0% | n/a Browse Formulary | |||||
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HAP Senior Plus - Henry Ford (HMO) - H2312-006-0 Benefit Details |
Oakland | $55.00 | 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 | |||||||||
Molina Medicare Options (HMO) - H5926-002-0 Benefit Details |
Oakland | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $50.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Oakland | $61.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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 | |||||
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 | |||||||||
HAP Senior Plus - Henry Ford (HMO) - H2312-004-0 Benefit Details |
Oakland | $69.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: 33% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Medicare Plus Blue PPO Vitality (PPO) - H9572-002-6 Benefit Details |
Oakland | $69.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,500 Browse Formulary | |||||
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HealthPlus MedicarePlus - AdvantageHMO Option 1 (HMO) - H2354-001-0 Benefit Details |
Oakland | $75.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $74.00 Specialty Tier Drugs: 25% | $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 | |||||||||
PriorityMedicare Value (HMO-POS) - H2320-021-0 Benefit Details |
Oakland | $83.70 | $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 | |||||
BCN Advantage Option 2 (HMO-POS) - H5883-002-7 Benefit Details |
Oakland | $89.00 | $0 | Many Generics | Tier 1: tbd | $4,200 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-008-0 Benefit Details |
Oakland | $95.00 | 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 | |||||||||
Fidelis Secure Comfort Plus (HMO SNP) - H2323-006-0 Benefit Details |
Oakland | $98.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
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HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Oakland | $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 | |||||
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 | |||||
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 | |||||||||
HAP Senior Plus - Henry Ford (HMO) - H2312-009-0 Benefit Details |
Oakland | $108.00 | $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 | |||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-6 Benefit Details |
Oakland | $109.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,000 Browse Formulary | |||||
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HAP Senior Plus - Expanded Network (HMO-POS) - H2312-007-0 Benefit Details |
Oakland | $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 |
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Service | Exper. | Cost Info | |||||||||
Erickson Advantage Signature without Drugs (HMO-POS) - H5652-002-0 Benefit Details |
Oakland | $121.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,500 | ||||||
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HealthPlus MedicarePlus - AdvantageHMO Option 2 (HMO) - H2354-013-0 Benefit Details |
Oakland | $121.00 | $0 | Many Generics | Generic Drugs: $6.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
PriorityMedicare (HMO-POS) - H2320-019-0 Benefit Details |
Oakland | $122.10 | $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 | |||||
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 | |||||||||
Fidelis Secure Independence (HMO SNP) - H2323-007-0 Benefit Details |
Oakland | $149.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $65.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
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Alliance Medicare PPO (PPO) - H2322-001-0 Benefit Details |
Oakland | $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 | |||||
PriorityMedicare Select (PPO) - H4875-015-0 Benefit Details |
Oakland | $153.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $8.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 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 |
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Service | Exper. | Cost Info | |||||||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-010-0 Benefit Details |
Oakland | $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 | |||||
Erickson Advantage Champion (HMO-POS SNP) - H5652-004-0 Benefit Details |
Oakland | $159.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
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Erickson Advantage Signature with Drugs (HMO-POS) - H5652-001-0 Benefit Details |
Oakland | $159.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $37.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Specialty Tier Drugs: 33% | $2,500 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
BCN Advantage Option 3 (HMO-POS) - H5883-003-5 Benefit Details |
Oakland | $181.00 | $0 | Many Generics | Tier 1: tbd | $4,000 Browse Formulary | |||||
Alliance Medicare PPO (PPO) - H2322-004-0 Benefit Details |
Oakland | $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 | |||||
Medicare Plus Blue PPO Assure (PPO) - H9572-003-6 Benefit Details |
Oakland | $203.00 | $0 | Many Generics | Tier 1: tbd | $4,000 Browse Formulary | |||||
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