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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Care1st AdvantageOptimum Plan (HMO) - H5928-020-0 Benefit Details |
San Joaquin | $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 | |||||
Kaiser Permanente Senior Advantage Basic SnJoaq (HMO) - H0524-043-0 Benefit Details |
San Joaquin | $0.00 | $0 | All Generics, Few Brands | Tier 1: tbd | $3,400 Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) - H0524-030-0 Benefit Details |
San Joaquin | $ 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 | |||||
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) - H0562-088-0 Benefit Details |
San Joaquin | $29.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
SCAN Options (HMO) - H5811-005-0 Benefit Details |
San Joaquin | $29.00 | $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% | $5,000 Browse Formulary | |||||
SCAN Connections (HMO SNP) - H5811-002-0 Benefit Details |
San Joaquin | $ 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 | |||||||||
SCAN Classic (HMO) - H5811-001-0 Benefit Details |
San Joaquin | $39.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $35.00 Tier 4: $55.00 Tier 5: 33% | $5,000 Browse Formulary | |||||
Kaiser Permanente Senior Advantage Enhanced SnJoaq (HMO) - H0524-042-0 Benefit Details |
San Joaquin | $75.00 | $0 | All Generics, Few Brands | Tier 1: tbd | $3,400 Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-045-0 Benefit Details |
San Joaquin | $89.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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 Healthy Heart (HMO) - H0562-036-0 Benefit Details |
San Joaquin | $133.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
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