2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
AARP MedicareComplete Plus (HMO-POS) - H1111-002-0 Benefit Details |
Richmond | $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: $92.00 Tier 5: 33% | $4,250 Browse Formulary | |||||
Advantra Elite (HMO) - H5302-008-0 Benefit Details |
Richmond | $0.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $40.00 Tier 3: $78.00 Tier 4: 33% | $3,300 Browse Formulary | |||||
Advantra Silver (HMO-POS) - H5302-003-0 Benefit Details |
Richmond | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $45.00 Tier 3: $80.00 Tier 4: 33% | $4,375 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Any, Any, Any Gold (PFFS) - H8098-001-0 Benefit Details |
Richmond | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $15.00 Tier 3: $45.00 Tier 4: $85.00 Tier 5: 33% | $6,700 Browse Formulary | |||||
-- | -- | ||||||||||
Any, Any, Any Gold MA Only (PFFS) - H8098-003-0 Benefit Details |
Richmond | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | -- | ||||||||||
Care Improvement Plus Gold Rx (PPO SNP) - H6528-016-0 Benefit Details |
Richmond | $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 |
|||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R9896-009-0 Benefit Details |
Richmond | $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 | |||||
Humana Gold Plus H4141-004 (HMO) - H4141-004-0 Benefit Details |
Richmond | $0.00 | $0 | Few Generics, Few Brands | Tier 1: $5.00 Tier 2: $42.00 Tier 3: $85.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-064 (Regional PPO) - R5826-064-0 Benefit Details |
Richmond | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,900 | ||||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Southeast Community Care - Plus (HMO) - H5578-009-0 Benefit Details |
Richmond | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $4,950 Browse Formulary | |||||
-- | |||||||||||
WellCare Value (HMO-POS) - H1112-027-0 Benefit Details |
Richmond | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $39.00 Tier 3: $75.00 Tier 4: 33% | $4,000 Browse Formulary | |||||
WellCare Access (HMO SNP) - H1112-006-0 Benefit Details |
Richmond | $ 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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
UnitedHealthcare Dual Complete (HMO-POS SNP) - H1111-004-0 Benefit Details |
Richmond | $ 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 | |||||
Today's Options Premier 400 (PFFS) - H6169-012-0 Benefit Details |
Richmond | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | -- | -- | |||||||||
Humana Gold Plus SNP-DE H4141-005 (HMO SNP) - H4141-005-0 Benefit Details |
Richmond | $ 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: $35.00 Tier 3: $69.00 Tier 4: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H5214-004 (PPO) - H5214-004-0 Benefit Details |
Richmond | $27.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $4,900 Browse Formulary | |||||
Care Improvement Plus Dual Advantage (PPO SNP) - H6528-017-0 Benefit Details |
Richmond | $ 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 | |||||
-- | |||||||||||
Care Improvement Plus Silver Rx (PPO SNP) - H6528-015-0 Benefit Details |
Richmond | $31.20 | $185 | 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 | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R9896-008-0 Benefit Details |
Richmond | $33.60 | $145 | 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 Medicare Advantage (PPO) - H6528-006-0 Benefit Details |
Richmond | $38.00 | $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% | $6,700 Browse Formulary | |||||
-- | |||||||||||
Today's Options Premier 200 (PFFS) - H6169-050-0 Benefit Details |
Richmond | $50.00 | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 450B (PFFS) - H6169-032-0 Benefit Details |
Richmond | $59.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
-- | -- | -- | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R9896-012-0 Benefit Details |
Richmond | $70.00 | $230 | 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 | |||||
HumanaChoice R5826-077 (Regional PPO) - R5826-077-0 Benefit Details |
Richmond | $76.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 28% | $5,900 Browse Formulary | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 250A (PFFS) - H6169-054-0 Benefit Details |
Richmond | $112.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
-- | -- | -- |
|