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 |
|||||||||
AARP MedicareComplete Plan 1 (HMO) - H0151-001-0 Benefit Details |
Elmore | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $45.00 Tier 4: $92.00 Tier 5: 33% | $4,450 Browse Formulary | |||||
HealthyAdvantage (HMO) - H0150-012-0 Benefit Details |
Elmore | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HealthyAdvantage Preferred (HMO) - H0150-001-0 Benefit Details |
Elmore | $0.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $12.00 Tier 3: $45.00 Tier 4: $70.00 Tier 5: 33% | $3,400 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 R5826-065 (Regional PPO) - R5826-065-0 Benefit Details |
Elmore | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
-- | |||||||||||
VIVA Medicare Plus Rx (HMO) - H0154-001-0 Benefit Details |
Elmore | $0.00 | $125 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $75.00 Tier 5: 29% | $6,700 Browse Formulary | |||||
VIVA Medicare Plus Rx Extra Value (HMO SNP) - H0154-012-0 Benefit Details |
Elmore | $ 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: 15% Tier 2: 15% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
VIVA Medicare Plus Select (HMO) - H0154-008-0 Benefit Details |
Elmore | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
UnitedHealthcare Dual Complete (HMO SNP) - H0151-015-0 Benefit Details |
Elmore | $ 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: 15% Tier 2: 15% | n/a Browse Formulary | |||||
TotalCare (HMO SNP) - H0150-007-0 Benefit Details |
Elmore | $ 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: 15% Tier 2: 15% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthyAdvantage Premier (HMO-POS) - H0150-023-0 Benefit Details |
Elmore | $38.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $12.00 Tier 3: $45.00 Tier 4: $70.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
HumanaChoice H1681-005 (PPO) - H1681-005-0 Benefit Details |
Elmore | $39.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $38.00 Tier 3: $80.00 Tier 4: 33% | $4,900 Browse Formulary | |||||
HumanaChoice R5826-001 (Regional PPO) - R5826-001-0 Benefit Details |
Elmore | $59.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $4,900 Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Blue Advantage Complete (PPO) - H0104-011-5 Benefit Details |
Elmore | $99.00 | $130 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $8.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 29% | $3,400 Browse Formulary | |||||
VIVA Medicare Plus Rx Premier (HMO) - H0154-011-0 Benefit Details |
Elmore | $99.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $75.00 Tier 5: 33% | $6,700 Browse Formulary | |||||
Blue Advantage Premier (PPO) - H0104-010-3 Benefit Details |
Elmore | $199.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $75.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
|