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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Anthem Medicare Preferred Classic (PPO) - H4909-007-0 Benefit Details |
Mathews | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Anthem Medicare Preferred Standard (PPO) - H4909-001-0 Benefit Details |
Mathews | $0.00 | $0 | Many Generics | Generic Drugs: 0% Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: 0% | $4,500 Browse Formulary | |||||
HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Mathews | $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 | |||||||||
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 | ||||||
Optima Medicare Value (PPO) - H4908-005-0 Benefit Details |
Mathews | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Optima Medicare Value Plus (PPO) - H4908-006-0 Benefit Details |
Mathews | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $4.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $60.00 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 | |||||||||
HumanaChoice H2542-002 (PPO) - H2542-002-0 Benefit Details |
Mathews | $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% | $3,400 Browse Formulary | |||||
Anthem Medicare Preferred Premier (PPO) - H4909-004-0 Benefit Details |
Mathews | $39.00 | $0 | Many Generics | Generic Drugs: $7.00 Preferred Brand Drugs: $43.00 Non-Preferred Brand Drugs: $85.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% Supplemental Drugs: $7.00 | $3,350 Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Mathews | $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 | |||||||||
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 | |||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Mathews | $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 | |||||
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 | |||||
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