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 SecureHorizons Essential (HMO) - H0543-121-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Aetna Medicare Select Plan (HMO) - H0523-052-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $40.00 Tier 4: $85.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
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Anthem Medicare Preferred Standard (PPO) - H8552-001-0 Benefit Details |
San Diego | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $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 | |||||||||
Blue Cross Senior Secure Plan I (HMO) - H0564-047-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $3,400 Browse Formulary | |||||
Care1st AdvantageOptimum Plan (HMO) - H5928-010-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Tier 1: $0.00 Tier 2: $5.00 Tier 3: $30.00 Tier 4: $50.00 Tier 5: 30% | $3,400 Browse Formulary | |||||
Health Net Healthy Heart (HMO) - H0562-012-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Tier 1: tbd | $3,400 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 | |||||||||
Health Net Seniority Plus Green (HMO) - H0562-044-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Kaiser Permanente Senior Advantage San Diego (HMO) - H0524-037-0 Benefit Details |
San Diego | $0.00 | $0 | All Generics, Few Brands | Tier 1: tbd | $3,400 Browse Formulary | |||||
Sharp SecureHorizons Plan by UnitedHealthcare (HMO) - H0543-145-0 Benefit Details |
San Diego | $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% | $6,700 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 | |||||||||
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) - H0524-029-0 Benefit Details |
San Diego | $ 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 | |||||
Humana Gold Plus H0108-008 (HMO) - H0108-008-0 Benefit Details |
San Diego | $19.00 | $0 | Few Generics, Few Brands | Tier 1: $0.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
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Health Net Healthy Heart Plan 2 (HMO) - H0562-086-0 Benefit Details |
San Diego | $20.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 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 | |||||||||
SCAN Classic (HMO) - H5425-005-0 Benefit Details |
San Diego | $20.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $10.00 Tier 3: $35.00 Tier 4: $70.00 Tier 5: 33% | $5,000 Browse Formulary | |||||
AARP MedicareComplete SecureHorizons Value (HMO) - H0543-013-0 Benefit Details |
San Diego | $25.00 | $0 | Some Generics | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $44.00 Tier 4: $92.00 Tier 5: 33% | $5,000 Browse Formulary | |||||
Molina Medicare Options (HMO) - H5810-002-0 Benefit Details |
San Diego | $29.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $20.00 Tier 3: $50.00 Tier 4: 33% | $3,350 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 | |||||||||
Care1st TotalDual Plan (HMO SNP) - H5928-009-0 Benefit Details |
San Diego | $ 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 | |||||
Molina Medicare Options Plus (HMO SNP) - H5810-001-0 Benefit Details |
San Diego | $ 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: $0.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 25% | n/a Browse Formulary | |||||
CommuniCare Advantage (HMO SNP) - H7086-001-0 Benefit Details |
San Diego | $ 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: $0.00 Tier 2: $60.00 | 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 | |||||||||
Health Net Seniority Plus Amber II (HMO SNP) - H0562-070-0 Benefit Details |
San Diego | $ 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 | |||||
Humana Gold Plus H0108-009 (HMO-POS) - H0108-009-0 Benefit Details |
San Diego | $39.00 | $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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Health Net Violet (PPO) - H5439-001-0 Benefit Details |
San Diego | $62.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 | |||||||||
AARP MedicareComplete SecureHorizons Premier (HMO) - H0543-060-0 Benefit Details |
San Diego | $69.00 | $0 | Some Generics | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $42.00 Tier 4: $88.00 Tier 5: 33% | $4,000 Browse Formulary | |||||
Health Net Seniority Plus Ruby Plan 2 (HMO) - H0562-040-0 Benefit Details |
San Diego | $69.00 | $0 | Many Generics | Tier 1: tbd | $5,000 Browse Formulary | |||||
SCAN Signature (HMO) - H5425-004-0 Benefit Details |
San Diego | $69.00 | $0 | Many Generics | Tier 1: $3.00 Tier 2: $8.00 Tier 3: $34.00 Tier 4: $70.00 Tier 5: 33% | $4,000 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 | |||||||||
Health Net Seniority Plus Ruby (HMO) - H0562-017-0 Benefit Details |
San Diego | $192.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
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