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) - H3456-001-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,750 Browse Formulary | |||||
AARP MedicareComplete Plus Essential (HMO-POS) - H3456-020-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,200 | ||||||
Advantra Bronze (PPO) - H9847-004-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $36.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $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 | |||||||||
Ambassador (PPO) - H6881-001-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
Ambassador Plus (PPO) - H6881-002-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $60.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
new | new | new | |||||||||
Blue Medicare HMO Medical Only (HMO) - H3449-012-0 Benefit Details |
Orange | $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 | |||||||||
Blue Medicare HMO Standard (HMO) - H3449-013-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 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 | |||||||||
Patriot (PFFS) - H4268-001-0 Benefit Details |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
Patriot Plus (PFFS) - H4268-002-0 Benefit Details |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic and Brand Drugs: 0% Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Generic and Non-Preferred Brand Drug: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
new | new | new | |||||||||
Southeast Community Care - Plus (HMO) - H2899-009-0 Sanctioned Plan |
Orange | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $15.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $89.00 Specialty Tier Drugs: 33% | $3,900 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 Advantage 650B powered by CCRx (PPO) - H5378-190-0 Sanctioned Plan |
Orange | $0.00 | $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% | $3,400 Browse Formulary | |||||
Today's Options Premier 600 (PFFS) - H6169-011-0 Sanctioned Plan |
Orange | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
Sterling Partners (PPO) - H9988-003-0 Benefit Details |
Orange | $9.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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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 | |||||||||
HumanaChoice H3405-001 (PPO) - H3405-001-0 Benefit Details |
Orange | $18.00 | $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% | $4,900 Browse Formulary | |||||
Advantra Gold (PPO) - H9847-001-0 Benefit Details |
Orange | $23.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $33.00 Non-Preferred Generic and Non-Preferred Brand Drug: $63.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Today's Options Premier 100 (PFFS) - H6169-001-0 Sanctioned Plan |
Orange | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 | |||||||||
Evercare Plan DH (HMO SNP) - H3456-016-0 Benefit Details |
Orange | $ 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 | |||||
Sterling Partners (PPO) - H9988-004-0 Benefit Details |
Orange | $30.70 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $18.00 Preferred Brand Drugs: $39.00 Specialty Tier Drugs: 25% | $5,000 Browse Formulary | |||||
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Today's Options Premier 650B powered by CCRx (PFFS) - H6169-031-0 Sanctioned Plan |
Orange | $31.00 | $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% | $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 | |||||||||
Evercare Plan IH (HMO SNP) - H3456-010-0 Benefit Details |
Orange | $34.20 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Southeast Community Care - Dual Plus (HMO SNP) - H2899-002-0 Sanctioned Plan |
Orange | $ 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 | |||||
Sterling Connect Basic (PFFS) - H3410-001-5 Benefit Details |
Orange | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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 | |||||||||
AARP MedicareComplete Choice (PPO) - H5516-001-0 Benefit Details |
Orange | $45.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,200 Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Orange | $58.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Statewide | $58.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 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 | |||||||||
Sterling Connect 1 (PFFS) - H3410-002-5 Benefit Details |
Orange | $59.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
new | new | new | |||||||||
Blue Medicare PPO Enhanced (PPO) - H3404-001-0 Benefit Details |
Orange | $62.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Orange | $64.00 | $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% | $5,900 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 R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Statewide | $64.00 | $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% | $5,900 Browse Formulary | |||||
Today's Options Advantage 150A powered by CCRx (PPO) - H5378-182-0 Sanctioned Plan |
Orange | $64.00 | $150 | Many Generics, Some Brands | 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% | $3,250 Browse Formulary | |||||
Today's Options Premier 150A powered by CCRx (PFFS) - H6169-021-0 Sanctioned Plan |
Orange | $74.00 | $150 | Many Generics, Some Brands | 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% | $3,250 Browse Formulary | |||||
new | new | new | |||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare HMO Enhanced (HMO) - H3449-005-0 Benefit Details |
Orange | $80.50 | $0 | Many Generics | Generic Drugs: $6.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Sterling Connect 2 (PFFS) - H3410-003-5 Benefit Details |
Orange | $80.70 | $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 | |||||
new | new | new | |||||||||
Blue Medicare PPO Enhanced Freedom (PPO) - H3404-002-0 Benefit Details |
Orange | $169.80 | $0 | Many Generics | Generic Drugs: $6.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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