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 Essential (HMO) - H0543-121-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
AARP MedicareComplete Plan 2 (HMO) - H0543-145-0 Benefit Details |
San Diego | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $44.00 Non-Preferred Generic and Non-Preferred Brand Drug: $88.00 Specialty Tier Drugs: 33% | $6,700 Browse Formulary | |||||
Aetna Medicare Select Plan (HMO) - H0523-052-0 Sanctioned Plan |
San Diego | $0.00 | $0 | n/a | Tier 1: Preferred Generic Drugs: $9.00 Tier 2: Non-Preferred Generic Drugs: $36.00 Tier 3: Preferred Brand Drugs: $40.00 Tier 4: Non-Preferred Brand Drugs: $85.00 Tier 5: Specialty Tier Drugs: 33% | 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 | |||||||||
Blue Cross Senior Secure Plan I (HMO) - H0564-047-0 Benefit Details |
San Diego | $0.00 | $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 | $3,400 Browse Formulary | |||||
Care1st Medicare Advantage Value Plan (HMO) - H5928-010-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Preferred Generic Drugs: 0% Generic Drugs: $5.00 Preferred Brand Drugs: $30.00 Non-Preferred Generic and Non-Preferred Brand Drug: $50.00 Specialty Tier Drugs: 30% | $3,400 Browse Formulary | |||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,300 | ||||||
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 | |||||||||
Freedom Blue Classic (Regional PPO) - R9943-004-0 Benefit Details |
Statewide | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,300 | ||||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
San Diego | $0.00 | $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 | $3,300 Browse Formulary | |||||
Freedom Blue Plan I (Regional PPO) - R9943-001-0 Benefit Details |
Statewide | $0.00 | $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 | $3,300 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 | |||||||||
Health Net Healthy Heart (HMO) - H0562-012-0 Sanctioned Plan |
San Diego | $0.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-044-0 Sanctioned Plan |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Kaiser Permanente Senior Advantage San Diego (HMO) - H0524-037-0 Benefit Details |
San Diego | $0.00 | $0 | All Generics | Generic Drugs: $10.00 Brand Drugs: $45.00 Specialty Tier Drugs: 25% | $3,400 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 | |||||||||
Care1st Dual Plus Plan (HMO SNP) - H5928-009-0 Benefit Details |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) - H0524-029-0 Benefit Details |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $12.00 Brand Drugs: $44.00 Specialty Tier Drugs: 25% | n/a Browse Formulary | |||||
SCAN Classic (HMO) - H5425-005-0 Benefit Details |
San Diego | $20.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Generic Drugs: $10.00 Preferred Brand Drugs: $33.00 Brand Drugs: $55.00 Specialty Tier Drugs: 33% | $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 | |||||||||
Aetna Medicare Premier Plan (HMO) - H0523-054-0 Sanctioned Plan |
San Diego | $21.70 | $0 | n/a | Tier 1: Preferred Generic Drugs: $5.00 Tier 2: Non-Preferred Generic Drugs: $35.00 Tier 3: Preferred Brand Drugs: $45.00 Tier 4: Non-Preferred Brand Drugs: $85.00 Tier 5: Specialty Tier Drugs: 33% | n/a Browse Formulary | |||||
Evercare Plan DH (HMO SNP) - H0543-141-0 Benefit Details |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
Molina Medicare Options (HMO) - H5810-002-0 Benefit Details |
San Diego | $24.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $5.00 Preferred Brand Drugs: $20.00 Non-Preferred Brand Drugs: $50.00 Specialty Tier Drugs: 33% | $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 | |||||||||
AARP MedicareComplete Value (HMO) - H0543-013-0 Benefit Details |
San Diego | $25.00 | $0 | Some Generics | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $44.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Health Net Seniority Plus Ruby Plan 1 (HMO) - H0562-086-0 Sanctioned Plan |
San Diego | $25.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
Molina Medicare Options Plus (HMO SNP) - H5810-001-0 Benefit Details |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 0% Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 25% | 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 | |||||||||
Humana Gold Plus H0108-008 (HMO) - H0108-008-0 Benefit Details |
San Diego | $27.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $79.00 Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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Health Net Seniority Plus Amber II (HMO SNP) - H0562-070-0 Sanctioned Plan |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | n/a Browse Formulary | |||||
CommuniCare Advantage (HMO SNP) - H7086-001-0 Benefit Details |
San Diego | $ for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: 0% Generic and Brand Drugs: $47.00 | 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 | |||||||||
Humana Gold Plus H0108-009 (HMO-POS) - H0108-009-0 Benefit Details |
San Diego | $51.00 | $0 | Few Generics, Few Brands | Preferred Generic Drugs: $6.00 Non-Preferred Generic and Preferred Brand Drugs: $42.00 Non-Preferred Brand Drugs: $79.00 Specialty Tier Drugs: 33% | $5,000 Browse Formulary | |||||
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AARP MedicareComplete Premier (HMO) - H0543-060-0 Benefit Details |
San Diego | $69.00 | $0 | Some Generics | Preferred Generic Drugs: $6.00 Generic and Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $82.00 Specialty Tier Drugs: 33% | $4,000 Browse Formulary | |||||
Health Net Seniority Plus Ruby Plan 2 (HMO) - H0562-040-0 Sanctioned Plan |
San Diego | $69.00 | $0 | Many Generics | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $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 | |||||||||
SCAN Signature (HMO) - H5425-004-0 Benefit Details |
San Diego | $69.00 | $0 | Many Generics | Preferred Generic Drugs: $4.00 Generic Drugs: $8.00 Preferred Brand Drugs: $33.00 Brand Drugs: $55.00 Specialty Tier Drugs: 33% | $4,000 Browse Formulary | |||||
Health Net Violet (PPO) - H5439-001-0 Sanctioned Plan |
San Diego | $89.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $45.00 Non-Preferred Generic and Non-Preferred Brand Drug: $90.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
Health Net Seniority Plus Ruby Plan 3 (HMO) - H0562-077-0 Sanctioned Plan |
San Diego | $199.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic Drugs: $5.00 Preferred Brand Drugs: $42.00 Non-Preferred Generic and Non-Preferred Brand Drug: $84.00 Injectable Drugs: 33% Specialty Tier Drugs: 33% | $3,400 Browse Formulary | |||||
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