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 H8145-097 (PFFS) - H8145-097-0 Benefit Details |
Carbon | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
New West Medicare (PPO) - H2701-003-0 Benefit Details |
Carbon | $16.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Humana Gold Choice H8145-096 (PFFS) - H8145-096-0 Benefit Details |
Carbon | $42.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,000 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 H6609-029 (PPO) - H6609-029-0 Benefit Details |
Carbon | $57.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $5.00 Non-Preferred Generic and Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Today's Options Advantage 850B powered by CCRx (PPO) - H5378-185-0 Sanctioned Plan |
Carbon | $59.00 | $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 | |||||
Humana Gold Choice H8145-095 (PFFS) - H8145-095-0 Benefit Details |
Carbon | $62.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 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 | |||||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Carbon | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Statewide | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
New West Medicare Enhanced (PPO) - H2701-001-0 Benefit Details |
Carbon | $85.30 | $0 | Many Generics | Generic Drugs: $10.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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