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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WINhealth Partners Green Plan (Cost) - H0602-044-0 Benefit Details |
Big Horn | $7.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
AB Basic Plan (Cost) - H0602-026-0 Benefit Details |
Big Horn | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
WINhealth Partners Green Plan + Rx (Cost) - H0602-045-0 Benefit Details |
Big Horn | $41.90 | $115 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $2.00 Non-Preferred Generic and Brand Drugs: $9.25 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 30% | $5,000 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 | |||||||||
WINhealth Partners Standard Plan (Cost) - H0602-013-0 Benefit Details |
Big Horn | $65.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | N/A | ||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Big Horn | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Statewide | $71.30 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 13% Preferred Brand Drugs: 26% Non-Preferred Brand Drugs: 50% Specialty Tier Drugs: 25% | $3,350 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 | |||||||||
WINhealth Partners Standard Plan + Rx (Cost) - H0602-023-0 Benefit Details |
Big Horn | $116.70 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Non-Preferred Generic and Brand Drugs: $10.00 Preferred Brand Drugs: $40.00 Non-Preferred Brand Drugs: $60.00 Specialty Tier Drugs: 33% | N/A Browse Formulary | |||||
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