2012 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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Humana Gold Choice H2944-166 (PFFS) - H2944-166-0 Benefit Details |
Mercer | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Medica Advantage Solution Std with Part D Option 1 (PFFS) - H2410-016-0 Benefit Details |
Mercer | $0.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,350 Browse Formulary | |||||
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Today's Options Premier 400 (PFFS) - H5421-046-0 Benefit Details |
Mercer | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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 | |||||||||
UnitedHealthcare MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details |
Mercer | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,200 | ||||||
UnitedHealthcare MedicareDirect Rx (PFFS) - H5435-014-0 Benefit Details |
Mercer | $28.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $93.00 Tier 5: 33% | $6,700 Browse Formulary | |||||
Today's Options Premier 200 (PFFS) - H5421-206-0 Benefit Details |
Mercer | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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 Choice H2944-019 (PFFS) - H2944-019-0 Benefit Details |
Mercer | $37.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $77.00 Tier 4: 33% | $5,400 Browse Formulary | |||||
Today's Options Premier Plus 450B (PFFS) - H5421-070-0 Benefit Details |
Mercer | $41.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
Medica Prime Solution Thrift with Part D Option 1 (Cost) - H2450-007-0 Benefit Details |
Mercer | $55.50 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $6,700 Browse Formulary | |||||
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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 | |||||||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Mercer | $84.40 | $155 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $11.00 Tier 3: $33.00 Tier 4: 45% | $3,400 Browse Formulary | |||||
Medica Prime Solution Value with Part D Option 1 (Cost) - H2450-022-0 Benefit Details |
Mercer | $85.50 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,350 Browse Formulary | |||||
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Today's Options Premier Plus 250A (PFFS) - H5421-212-0 Benefit Details |
Mercer | $98.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Medica Prime Solution Value with Part D Option 2 (Cost) - H2450-023-0 Benefit Details |
Mercer | $102.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,350 Browse Formulary | |||||
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Medica Prime Solution Basic with Part D Option 1 (Cost) - H2450-016-0 Benefit Details |
Mercer | $105.50 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,000 Browse Formulary | |||||
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Medica Prime Solution Basic with Part D Option 2 (Cost) - H2450-001-0 Benefit Details |
Mercer | $122.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,000 Browse Formulary | |||||
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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 | |||||||||
Medica Prime Solution Enhanced w/Part D Option 1 (Cost) - H2450-017-0 Benefit Details |
Mercer | $155.50 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,000 Browse Formulary | |||||
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Medica Prime Solution Value with Part D Option 3 (Cost) - H2450-028-0 Benefit Details |
Mercer | $161.20 | $0 | Many Generics | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,350 Browse Formulary | |||||
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Medica Prime Solution Enhanced w/Part D Option 2 (Cost) - H2450-002-0 Benefit Details |
Mercer | $172.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,000 Browse Formulary | |||||
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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 | |||||||||
Medica Prime Solution Basic with Part D Option 3 (Cost) - H2450-005-0 Benefit Details |
Mercer | $181.20 | $0 | Many Generics | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,000 Browse Formulary | |||||
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Medica Prime Solution Enhanced w/Part D Option 3 (Cost) - H2450-006-0 Benefit Details |
Mercer | $231.20 | $0 | Many Generics | Tier 1: $10.00 Tier 2: $34.00 Tier 3: $74.00 Tier 4: 25% | $3,000 Browse Formulary | |||||
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