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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Community HealthFirst Medicare Advantage (HMO) - H5826-006-0 Benefit Details |
Kitsap | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,800 | ||||||
Community HealthFirst Medicare Advantage Extra (HMO) - H5826-010-0 Benefit Details |
Kitsap | $0.00 | $0 | Many Generics | Generic Drugs: $7.00 Brand Drugs: $45.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Humana Gold Choice H8145-097 (PFFS) - H8145-097-0 Benefit Details |
Kitsap | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 | |||||||||
Group Health Cooperative Clear Care Basic (HMO) - H5050-001-0 Benefit Details |
Kitsap | $17.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,500 | ||||||
Group Health Cooperative Clear Care Vital (HMO) - H5050-013-0 Benefit Details |
Kitsap | $19.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $23.00 Non-Preferred Generic and Non-Preferred Brand Drug: 50% | $3,200 Browse Formulary | |||||
Evercare Plan IH (HMO SNP) - H5008-001-0 Benefit Details |
Kitsap | $28.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a 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 | |||||||||
Community HealthFirst MA Plan with Pharmacy (HMO) - H5826-008-0 Benefit Details |
Kitsap | $32.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Brand Drugs: $45.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
HumanaChoice H6609-014 (PPO) - H6609-014-0 Benefit Details |
Kitsap | $52.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
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HumanaChoice H6609-013 (PPO) - H6609-013-0 Benefit Details |
Kitsap | $72.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $36.00 Non-Preferred Brand Drugs: $80.00 Specialty Tier Drugs: 33% | $1,500 Browse Formulary | |||||
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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 H8145-109 (PFFS) - H8145-109-0 Benefit Details |
Kitsap | $92.00 | $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 | |||||
new | new | new | |||||||||
Regence MedAdvantage (PPO) - H5009-001-0 Benefit Details |
Kitsap | $98.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Group Health Cooperative Clear Care Essential (HMO) - H5050-009-0 Benefit Details |
Kitsap | $118.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $17.00 Non-Preferred Generic and Non-Preferred Brand Drug: 50% | $2,500 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 | |||||||||
Regence MedAdvantage + Rx Classic (PPO) - H5009-002-0 Benefit Details |
Kitsap | $144.00 | $190 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $35.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Injectable Drugs: 28% Specialty Tier Drugs: 28% | $3,400 Browse Formulary | |||||
Group Health Cooperative Clear Care Optimal (HMO) - H5050-004-0 Benefit Details |
Kitsap | $210.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Preferred Brand Drugs: $20.00 Non-Preferred Generic and Non-Preferred Brand Drug: 50% | $1,000 Browse Formulary | |||||
Regence MedAdvantage + Rx Enhanced (PPO) - H5009-004-0 Benefit Details |
Kitsap | $212.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Non-Preferred Generic Drugs: $35.00 Preferred Brand Drugs: $35.00 Non-Preferred Brand Drugs: $75.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
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