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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AARP MedicareComplete Choice (Regional PPO) - R7444-001-0 Benefit Details |
Bristol | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
AARP MedicareComplete Choice (Regional PPO) - R7444-001-0 Benefit Details |
Statewide | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,400 Browse Formulary | |||||
AARP MedicareComplete Essential (HMO) - H4102-025-0 Benefit Details |
Bristol | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,750 | ||||||
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 | |||||||||
AARP MedicareComplete Plus (HMO-POS) - H4102-001-0 Benefit Details |
Bristol | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $85.00 Specialty Tier Drugs: 33% | $4,250 Browse Formulary | |||||
Evercare Plan IP (PPO SNP) - H2228-002-0 Benefit Details |
Bristol | $33.70 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
BlueCHiP for Medicare Core (HMO) - H4152-004-0 Benefit Details |
Bristol | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,350 | ||||||
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 | |||||||||
BlueCHiP for Medicare Standard with Drugs (HMO) - H4152-013-0 Benefit Details |
Bristol | $45.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $38.00 Non-Preferred Brand Drugs: $90.00 Specialty Tier Drugs: 25% | $3,350 Browse Formulary | |||||
BlueCHiP for Medicare Plus (HMO) - H4152-005-0 Benefit Details |
Bristol | $149.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $2,400 Browse Formulary | |||||
BlueCHiP for Medicare Preferred (HMO-POS) - H4152-007-0 Benefit Details |
Bristol | $269.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $30.00 Non-Preferred Brand Drugs: $70.00 Specialty Tier Drugs: 25% | $1,750 Browse Formulary | |||||
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