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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AR Blue Cross - Medi-Pak Advantage MA (PFFS) - H4213-002-0 Benefit Details |
Bradley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Care Improvement Plus Gold Rx (PPO SNP) - H6528-010-0 Benefit Details |
Bradley | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $8.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 33% | n/a Browse Formulary | |||||
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Care Improvement Plus Gold Rx (Regional PPO SNP) - R3444-009-0 Benefit Details |
Bradley | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $8.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 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 | |||||||||
Humana Gold Choice H2944-197 (PFFS) - H2944-197-0 Benefit Details |
Bradley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Bradley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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UnitedHealthcare MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details |
Bradley | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,200 | ||||||
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 | |||||||||
Today's Options Premier 400 (PFFS) - H5421-047-0 Benefit Details |
Bradley | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
UnitedHealthcare MedicareDirect Rx (PFFS) - H5435-014-0 Benefit Details |
Bradley | $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 | |||||
Care Improvement Plus Dual Advantage (PPO SNP) - H6528-011-0 Benefit Details |
Bradley | $ 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: $10.00 Tier 2: $43.00 Tier 3: $95.00 Tier 4: 29% | n/a 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 | |||||||||
Care Improvement Plus Silver Rx (PPO SNP) - H6528-009-0 Benefit Details |
Bradley | $31.60 | $195 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 28% | n/a Browse Formulary | |||||
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Care Improvement Plus Silver Rx (Regional PPO SNP) - R3444-008-0 Benefit Details |
Bradley | $31.80 | $150 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 29% | n/a Browse Formulary | |||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R3444-011-0 Benefit Details |
Bradley | $ 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: $10.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 27% | 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 | |||||||||
Care Improvement Plus Medicare Advantage (PPO) - H6528-001-0 Benefit Details |
Bradley | $38.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $9.00 Tier 2: $44.00 Tier 3: $95.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
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HumanaChoice H7188-006 (PPO) - H7188-006-0 Benefit Details |
Bradley | $39.00 | $320 | Few Generics, Few Brands | Tier 1: $1.00 Tier 2: $5.00 Tier 3: 20% Tier 4: 30% | $5,000 Browse Formulary | |||||
WindsorSterling Silver Access Plan (PFFS) - H5006-018-9 Benefit Details |
Bradley | $40.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
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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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA-PD (PFFS) - H4213-005-0 Benefit Details |
Bradley | $55.20 | $170 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 25% | $6,700 Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Bradley | $60.00 | $215 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 27% | $6,700 Browse Formulary | |||||
Today's Options Premier 200 (PFFS) - H5421-207-0 Benefit Details |
Bradley | $60.00 | 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 | |||||||||
Today's Options Premier Plus 450B (PFFS) - H5421-065-0 Benefit Details |
Bradley | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
HumanaChoice H7188-003 (PPO) - H7188-003-0 Benefit Details |
Bradley | $66.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
Humana Gold Choice H2944-013 (PFFS) - H2944-013-0 Benefit Details |
Bradley | $69.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 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 | |||||||||
WindsorSterling Gold Access Plan (PFFS) - H5006-017-9 Benefit Details |
Bradley | $70.00 | $50 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $15.00 Tier 3: $34.00 Tier 4: $84.00 Tier 5: 30% | $4,000 Browse Formulary | |||||
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HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Bradley | $105.00 | $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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Today's Options Premier Plus 250A (PFFS) - H5421-213-0 Benefit Details |
Bradley | $119.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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