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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Humana Gold Choice H4785-003 (PFFS) - H4785-003-0 Benefit Details |
St. Tammany | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details |
St. Tammany | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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Peoples Health Choices 65 (HMO) - H1961-001-0 Benefit Details |
St. Tammany | $0.00 | $0 | All Generics and Some Brands | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $55.00 Tier 4: 20% | $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 | |||||||||
WellCare Dividend (HMO-POS) - H1903-024-0 Benefit Details |
St. Tammany | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $39.00 Tier 3: $75.00 Tier 4: 33% | $6,000 Browse Formulary | |||||
WellCare Value (HMO-POS) - H1903-022-0 Benefit Details |
St. Tammany | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $35.00 Tier 3: $60.00 Tier 4: 33% | $4,000 Browse Formulary | |||||
Humana Gold Plus SNP-DE H1951-034 (HMO SNP) - H1951-034-0 Benefit Details |
St. Tammany | $ 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: $68.00 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 |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Plus H1951-028 (HMO) - H1951-028-0 Benefit Details |
St. Tammany | $27.00 | $0 | Few Generics, Few Brands | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: $85.00 Tier 5: 33% | $6,700 Browse Formulary | |||||
Humana Gold Plus SNP-DE H1951-017 (HMO SNP) - H1951-017-0 Benefit Details |
St. Tammany | $ 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: $34.00 Tier 3: $70.00 Tier 4: 25% | n/a Browse Formulary | |||||
Peoples Health Secure Health (HMO SNP) - H1961-003-0 Benefit Details |
St. Tammany | $ 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: 25% Tier 2: 25% Tier 3: 25% 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 |
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Service | Exper. | Cost Info | |||||||||
WellCare Access (HMO SNP) - H1903-011-0 Benefit Details |
St. Tammany | $ 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 | |||||
HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details |
St. Tammany | $40.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $5,900 Browse Formulary | |||||
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Humana Gold Choice H4785-001 (PFFS) - H4785-001-0 Benefit Details |
St. Tammany | $45.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $41.00 Tier 3: $82.00 Tier 4: 33% | $5,000 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 | |||||||||
HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details |
St. Tammany | $67.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
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