2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Christian | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
-- | |||||||||||
Health Alliance Medicare PPO30 (PPO) - H1417-003-0 Benefit Details |
Christian | $45.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Christian | $67.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $5,000 Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H1418-007 (PPO) - H1418-007-0 Benefit Details |
Christian | $87.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $38.00 Tier 3: $80.00 Tier 4: 33% | $4,500 Browse Formulary | |||||
Health Alliance Medicare PPO30 Rx (PPO) - H1417-004-0 Benefit Details |
Christian | $89.00 | $105 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 Tier 2: $35.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 30% | $3,000 Browse Formulary | |||||
Health Alliance Medicare HMO20 (HMO) - H1463-001-0 Benefit Details |
Christian | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $1,500 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Health Alliance Medicare PPO10 (PPO) - H1417-001-0 Benefit Details |
Christian | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $1,500 | ||||||
Health Alliance Medicare HMO20 Rx (HMO) - H1463-003-0 Benefit Details |
Christian | $144.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 Tier 2: $35.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 30% | $1,500 Browse Formulary | |||||
Health Alliance Medicare PPO10 Rx (PPO) - H1417-002-0 Benefit Details |
Christian | $154.00 | $105 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 Tier 2: $35.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 30% | $1,500 Browse Formulary | |||||
|