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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ADVANTAGE Preferred (PPO) - H5508-002-0 Benefit Details |
Madison | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
ADVANTAGE Select (PPO) - H5508-005-0 Benefit Details |
Madison | $0.00 | $0 | Many Generics | Tier 1: $0.00 Tier 2: $0.00 Tier 3: $45.00 Tier 4: $80.00 Tier 5: 33% | $3,900 Browse Formulary | |||||
Blue Medicare Access Value (Regional PPO) - R5941-009-0 Benefit Details |
Madison | $0.00 | $60 | 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 | $4,200 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 | |||||||||
Humana Gold Plus H2012-009 (HMO) - H2012-009-0 Benefit Details |
Madison | $0.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $43.00 Tier 3: $87.00 Tier 4: 33% | $3,900 Browse Formulary | |||||
HumanaChoice R5826-066 (Regional PPO) - R5826-066-0 Benefit Details |
Madison | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
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ADVANTAGE Choice (PPO) - H5508-006-0 Benefit Details |
Madison | $29.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $4.00 Tier 3: $35.00 Tier 4: $75.00 Tier 5: 33% | $3,600 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 | |||||||||
Anthem Medicare Preferred Standard (PPO) - H1607-001-0 Benefit Details |
Madison | $29.00 | $60 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $4,000 Browse Formulary | |||||
UnitedHealthcare Dual Complete (PPO SNP) - H1509-004-0 Benefit Details |
Madison | $ 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 | |||||
UnitedHealthcare Nursing Home Plan (PPO SNP) - H1509-006-0 Benefit Details |
Madison | $35.90 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | 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 | |||||||||
AARP MedicareComplete Choice (PPO) - H1509-007-0 Benefit Details |
Madison | $38.00 | $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% | $4,900 Browse Formulary | |||||
Blue Medicare Access Standard (Regional PPO) - R5941-003-0 Benefit Details |
Madison | $43.00 | $60 | 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 | |||||
HumanaChoice H1510-001 (PPO) - H1510-001-0 Benefit Details |
Madison | $49.00 | $0 | Few Generics, Few Brands | Tier 1: $8.00 Tier 2: $42.00 Tier 3: $83.00 Tier 4: 33% | $5,000 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 | |||||||||
Today's Options Premier 400 (PFFS) - H6169-013-0 Benefit Details |
Madison | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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Today's Options Advantage Plus 450F (PPO) - H5378-184-0 Benefit Details |
Madison | $51.00 | $75 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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Anthem Medicare Preferred Select (PPO) - H1607-004-0 Benefit Details |
Madison | $64.00 | $60 | 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 | |||||
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 | |||||||||
ADVANTAGE Enhanced (PPO) - H5508-001-0 Benefit Details |
Madison | $69.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $4.00 Tier 3: $35.00 Tier 4: $75.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
Humana Gold Choice H8145-011 (PFFS) - H8145-011-0 Benefit Details |
Madison | $69.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $82.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
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HumanaChoice R5826-008 (Regional PPO) - R5826-008-0 Benefit Details |
Madison | $71.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 28% | $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 | |||||||||
Today's Options Premier 200 (PFFS) - H6169-051-0 Benefit Details |
Madison | $80.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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Today's Options Premier Plus 450C (PFFS) - H6169-033-0 Benefit Details |
Madison | $87.00 | $35 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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Today's Options Advantage Plus 250A (PPO) - H5378-200-0 Benefit Details |
Madison | $122.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 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 | |||||||||
Today's Options Premier Plus 250A (PFFS) - H6169-024-0 Benefit Details |
Madison | $147.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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ADVANTAGE Elite (PPO) - H5508-007-0 Benefit Details |
Madison | $151.00 | $0 | Many Generics | Tier 1: $0.00 Tier 2: $0.00 Tier 3: $45.00 Tier 4: $80.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
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