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 Plan 2 (HMO) - H0543-147-0 Benefit Details |
Stanislaus | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $7.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 33% | $4,900 Browse Formulary | |||||
Care1st AdvantageOptimum Plan (HMO) - H5928-022-0 Benefit Details |
Stanislaus | $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 Stanis (HMO) - H0524-041-0 Benefit Details |
Stanislaus | $0.00 | $0 | All Generics, Few Brands | 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 | |||||||||
StartSmart with CareMore (HMO) - H0544-028-0 Benefit Details |
Stanislaus | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $95.00 Tier 5: 33% Tier 6: $35.00 | $3,400 Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) - H0524-030-0 Benefit Details |
Stanislaus | $ 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 | |||||
CareMore Value Plus (HMO) - H0544-027-0 Benefit Details |
Stanislaus | $49.00 | $0 | All Generics | Tier 1: $0.00 Tier 2: $5.00 Tier 3: $30.00 Tier 4: $85.00 Tier 5: 33% Tier 6: $25.00 | $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 | |||||||||
CareMore Breathe (HMO SNP) - H0544-031-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Tier 1: $0.00 Tier 2: $5.00 Tier 3: $30.00 Tier 4: $85.00 Tier 5: 33% Tier 6: $0.00 | n/a Browse Formulary | |||||
CareMore Diabetes (HMO SNP) - H0544-032-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Tier 1: $0.00 Tier 2: $5.00 Tier 3: $30.00 Tier 4: $85.00 Tier 5: 33% Tier 6: $0.00 | n/a Browse Formulary | |||||
CareMore Heart (HMO SNP) - H0544-036-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Tier 1: $0.00 Tier 2: $5.00 Tier 3: $30.00 Tier 4: $85.00 Tier 5: 33% Tier 6: $0.00 | 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 | |||||||||
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) - H0524-040-0 Benefit Details |
Stanislaus | $63.00 | $0 | All Generics, Few Brands | Tier 1: tbd | $3,400 Browse Formulary | |||||
AARP MedicareComplete SecureHorizons Plan 1 (HMO) - H0543-036-0 Benefit Details |
Stanislaus | $89.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $6.00 Tier 3: $45.00 Tier 4: $88.00 Tier 5: 33% | $4,900 Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-045-0 Benefit Details |
Stanislaus | $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 | |||||||||
Anthem Medicare Preferred Standard (PPO) - H8552-005-0 Benefit Details |
Stanislaus | $131.00 | $316 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $2.00 Tier 2: $5.00 Tier 3: $43.00 Tier 4: $90.00 Tier 5: 25% Tier 6: 25% | $3,400 Browse Formulary | |||||
new | new | new | |||||||||
Health Net Healthy Heart (HMO) - H0562-053-0 Benefit Details |
Stanislaus | $135.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,400 Browse Formulary | |||||
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