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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HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Branch | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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Humana Gold Choice H2944-198 (PFFS) - H2944-198-0 Benefit Details |
Branch | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
PriorityMedicare Value (HMO-POS) - H2320-021-0 Benefit Details |
Branch | $42.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $9.00 Tier 2: $40.00 Tier 3: $81.00 Tier 4: 33% | $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 | |||||||||
Humana Gold Choice H2944-044 (PFFS) - H2944-044-0 Benefit Details |
Branch | $61.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $6,000 Browse Formulary | |||||
Medicare Plus Blue PPO Vitality (PPO) - H9572-002-4 Benefit Details |
Branch | $63.00 | $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% | $5,500 Browse Formulary | |||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Branch | $65.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $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 400 (PFFS) - H5421-057-0 Benefit Details |
Branch | $90.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Branch | $96.00 | $0 | Few Generics, Few Brands | Tier 1: $8.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
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Today's Options Premier Plus 450C (PFFS) - H5421-075-0 Benefit Details |
Branch | $102.00 | $35 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $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 | |||||||||
PriorityMedicare (HMO-POS) - H2320-019-0 Benefit Details |
Branch | $119.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $8.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
Today's Options Premier 200 (PFFS) - H5421-211-0 Benefit Details |
Branch | $125.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
PriorityMedicare Select (PPO) - H4875-015-0 Benefit Details |
Branch | $142.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $8.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $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 | |||||||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-4 Benefit Details |
Branch | $143.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $3.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 25% Tier 5: 30% | $5,000 Browse Formulary | |||||
Today's Options Premier Plus 250A (PFFS) - H5421-215-0 Benefit Details |
Branch | $159.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
Medicare Plus Blue PPO Assure (PPO) - H9572-003-4 Benefit Details |
Branch | $204.00 | $0 | Many Generics | Tier 1: $3.00 Tier 2: $40.00 Tier 3: $95.00 Tier 4: 25% Tier 5: 30% | $4,000 Browse Formulary | |||||
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