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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San Juan Medicare Plus - Standard (HMO) - H3251-024-0 Benefit Details |
San Juan | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $7.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $3,350 Browse Formulary | |||||
Molina Medicare Options (HMO) - H9082-002-0 Benefit Details |
San Juan | $25.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
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Presbyterian MediCare PPO Plan 1 (PPO) - H3206-003-0 Benefit Details |
San Juan | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
San Juan Medicare Plus - Enhanced (HMO-POS) - H3251-025-0 Benefit Details |
San Juan | $51.50 | $0 | Many Generics | Preferred Generic Drugs: $10.00 Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 33% | $2,750 Browse Formulary | |||||
Presbyterian MediCare PPO Plan 2 with Rx (PPO) - H3206-001-0 Benefit Details |
San Juan | $86.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Specialty Tier Drugs: 30% | $3,400 Browse Formulary | |||||
Presbyterian MediCare PPO Plan 3 with Rx (PPO) - H3206-002-0 Benefit Details |
San Juan | $107.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $40.00 Non-Preferred Generic and Non-Preferred Brand Drug: $75.00 Specialty Tier Drugs: 30% | $3,000 Browse Formulary | |||||
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