2011 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Geisinger Gold Reserve (MSA) - H8468-001-0 Benefit Details |
Potter | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
FreedomBlue PPO HD Rx (PPO) - H3916-020-0 Benefit Details |
Potter | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Geisinger Gold Classic 3 (HMO) - H3954-098-0 Benefit Details |
Potter | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,200 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Geisinger Gold Preferred 2 (PPO) - H3924-047-0 Benefit Details |
Potter | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-062 (Regional PPO) - R5826-062-0 Benefit Details |
Potter | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-062 (Regional PPO) - R5826-062-0 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 |
|||||
Service | Exper. | Cost Info | |||||||||
SecurityBlue HD (HMO) - H3957-037-0 Benefit Details |
Potter | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Today's Options Premier 800 (PFFS) - H2816-008-0 Sanctioned Plan |
Potter | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
new | new | new | |||||||||
Humana Gold Choice H8145-055 (PFFS) - H8145-055-0 Benefit Details |
Potter | $20.00 | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
SecurityBlue Value (HMO) - H3957-025-0 Benefit Details |
Potter | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Geisinger Gold Preferred 2 $0 Deductible Rx (PPO) - H3924-048-0 Benefit Details |
Potter | $30.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HumanaChoice H6900-001 (PPO) - H6900-001-0 Benefit Details |
Potter | $31.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $7.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier 850B powered by CCRx (PFFS) - H2816-020-0 Sanctioned Plan |
Potter | $33.00 | $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 | |||||
new | new | new | |||||||||
Geisinger Gold Classic 3 $0 Deductible Rx (HMO) - H3954-100-0 Benefit Details |
Potter | $36.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $2,200 Browse Formulary | |||||
Today's Options Premier 100 (PFFS) - H2816-002-0 Sanctioned Plan |
Potter | $47.00 | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-052 (PFFS) - H8145-052-0 Benefit Details |
Potter | $49.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $5,500 Browse Formulary | |||||
new | new | new | |||||||||
Geisinger Gold Classic 2 (HMO) - H3954-009-0 Benefit Details |
Potter | $57.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-081 (Regional PPO) - R5826-081-0 Benefit Details |
Potter | $60.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $7,500 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-081 (Regional PPO) - R5826-081-0 Benefit Details |
Statewide | $60.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $7,500 Browse Formulary | |||||
SecurityBlue ValueRx (HMO) - H3957-032-0 Benefit Details |
Potter | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
FreedomBlue PPO Select (PPO) - H3916-024-0 Benefit Details |
Potter | $68.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $90.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Geisinger Gold Preferred 1 (PPO) - H3924-001-0 Benefit Details |
Potter | $78.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,550 | ||||||
HumanaChoice R5826-002 (Regional PPO) - R5826-002-0 Benefit Details |
Potter | $80.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
HumanaChoice R5826-002 (Regional PPO) - R5826-002-0 Benefit Details |
Statewide | $80.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $8.00 Non-Preferred Generic and Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $84.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Geisinger Gold Classic 2 $0 Deductible Rx (HMO) - H3954-039-0 Benefit Details |
Potter | $84.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Today's Options Premier 150A powered by CCRx (PFFS) - H2816-014-0 Sanctioned Plan |
Potter | $98.00 | $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 | |||||||||
Geisinger Gold Classic 1 (HMO) - H3954-003-0 Benefit Details |
Potter | $123.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,800 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Geisinger Gold Preferred 1 $0 Deductible Rx (PPO) - H3924-003-0 Benefit Details |
Potter | $125.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $2,550 Browse Formulary | |||||
Geisinger Gold Secure 3 (HMO SNP) - H3954-134-0 Benefit Details |
Potter | $133.00 | $0 | Few Generics | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
SecurityBlue Standard (HMO) - H3957-006-0 Benefit Details |
Potter | $143.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $7.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Geisinger Gold Classic 1 $0 Deductible Rx (HMO) - H3954-021-0 Benefit Details |
Potter | $156.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $6.00 Preferred Brand Drugs: $39.00 Brand Drugs: $69.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
FreedomBlue PPO Classic (PPO) - H3916-002-0 Benefit Details |
Potter | $157.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
SecurityBlue Deluxe (HMO) - H3957-021-0 Benefit Details |
Potter | $175.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
FreedomBlue PPO Platinum (PPO) - H3916-027-0 Benefit Details |
Potter | $226.00 | $0 | Many Generics | Generic Drugs: $6.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
|