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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SecureHorizons MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details |
Merrimack | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,200 | ||||||
SmartValue Classic (PFFS) - H1689-012-0 Benefit Details |
Merrimack | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
SecureHorizons MedicareDirect Rx (PFFS) - H5435-014-0 Benefit Details |
Merrimack | $20.00 | $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: $88.00 Specialty Tier Drugs: 33% | $5,200 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 Premier 800 (PFFS) - H3333-039-0 Sanctioned Plan |
Merrimack | $28.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
SmartValue Plus (PFFS) - H1689-013-0 Benefit Details |
Merrimack | $42.00 | $0 | Many Generics | Generic Drugs: $8.00 Preferred Brand Drugs: $44.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $8.00 | $5,000 Browse Formulary | |||||
Humana Gold Choice H2944-163 (PFFS) - H2944-163-0 Benefit Details |
Merrimack | $64.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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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 | |||||||||
Humana Gold Choice H2944-073 (PFFS) - H2944-073-0 Benefit Details |
Merrimack | $86.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $39.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $4,500 Browse Formulary | |||||
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Today's Options Premier 850F powered by CCRx (PFFS) - H3333-057-0 Sanctioned Plan |
Merrimack | $89.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic and Preferred Brand Drugs: $4.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $80.00 Specialty Tier Drugs: 25% | $6,700 Browse Formulary | |||||
Humana Gold Choice H2944-106 (PFFS) - H2944-106-0 Benefit Details |
Merrimack | $91.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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