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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AARP MedicareComplete Plus (HMO-POS) - H0316-002-0 Benefit Details |
Cochise | $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: $95.00 Tier 5: 33% | $4,900 Browse Formulary | |||||
Health Net Green (HMO) - H0351-030-0 Benefit Details |
Cochise | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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Health Net Ruby 4 (HMO) - H0351-035-0 Benefit Details |
Cochise | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 | |||||||||
Humana Reader's Digest Healthy Living Plan (HMO-POS) - H0307-009-0 Benefit Details |
Cochise | $0.00 | $0 | Few Generics, Few Brands | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $43.00 Tier 4: $87.00 Tier 5: 33% | $5,000 Browse Formulary | |||||
Humana Reader's Digest Healthy Living Plan (Regional PPO) - R5826-070-0 Benefit Details |
Cochise | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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UnitedHealthcare Dual Complete (HMO SNP) - H0321-002-0 Benefit Details |
Cochise | $ 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 |
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Service | Exper. | Cost Info | |||||||||
University Physicians Care Advantage (HMO SNP) - H7352-004-0 Benefit Details |
Cochise | $ 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: 0% Tier 2: 0% | n/a Browse Formulary | |||||
Health Net Amber (HMO SNP) - H0351-029-0 Benefit Details |
Cochise | $ 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 | |||||
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Health Net Ruby 1 (HMO) - H0351-014-0 Benefit Details |
Cochise | $39.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,300 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 | |||||||||
Humana Reader's Digest Healthy Living Plan (PPO) - H0317-004-0 Benefit Details |
Cochise | $86.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $40.00 Tier 3: $82.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
Humana Reader's Digest Healthy Living Plan (Regional PPO) - R5826-014-0 Benefit Details |
Cochise | $129.00 | $0 | Few Generics, Few Brands | Tier 1: $0.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 33% | $5,000 Browse Formulary | |||||
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Humana Reader's Digest Healthy Living Plan (Regional PPO) - R5826-076-0 Benefit Details |
Cochise | $149.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 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 | |||||||||
Humana Gold Choice H8145-103 (PFFS) - H8145-103-0 Benefit Details |
Cochise | $174.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
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