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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Group Health Cooperative Clear Care Basic (HMO) - H5050-001-0 Benefit Details |
Mason | $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 |
Mason | $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 | |||||
Sterling Connect Basic (PFFS) - H3410-001-3 Benefit Details |
Mason | $19.00 | 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 |
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Service | Exper. | Cost Info | |||||||||
Community HealthFirst MA Plan with Pharmacy (HMO) - H5826-009-0 Benefit Details |
Mason | $30.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Brand Drugs: $39.00 Specialty Tier Drugs: 33% | $2,800 Browse Formulary | |||||
Sterling Connect 1 (PFFS) - H3410-002-3 Benefit Details |
Mason | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
new | new | new | |||||||||
Sterling Connect 2 (PFFS) - H3410-003-3 Benefit Details |
Mason | $60.70 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $18.00 Preferred Brand Drugs: $40.00 Specialty Tier Drugs: 25% | $4,000 Browse Formulary | |||||
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 | |||||||||
Community HealthFirst MA Plan, Enhanced Pharmacy (HMO) - H5826-012-0 Benefit Details |
Mason | $66.00 | $0 | Many Generics | Generic Drugs: $7.00 Brand Drugs: $37.00 Specialty Tier Drugs: 33% | $2,300 Browse Formulary | |||||
Group Health Cooperative Clear Care Essential (HMO) - H5050-009-0 Benefit Details |
Mason | $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 | |||||
Group Health Cooperative Clear Care Optimal (HMO) - H5050-004-0 Benefit Details |
Mason | $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 | |||||
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