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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BCN Advantage HMO-POS Basic (HMO-POS) - H5883-004-5 Benefit Details |
Oakland | $0.00 | $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% | $5,200 Browse Formulary | |||||
HealthPlus MedicarePlus-AdvantageHMO-POS Option 3 (HMO-POS) - H2354-015-0 Benefit Details |
Oakland | $0.00 | $320 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $33.00 Tier 3: $64.00 Tier 4: 25% | $6,700 Browse Formulary | |||||
HumanaChoice R5826-053 (Regional PPO) - R5826-053-0 Benefit Details |
Oakland | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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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 | |||||||||
Molina Medicare Options Plus (HMO SNP) - H5926-001-0 Benefit Details |
Oakland | $ 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 | |||||
BCN Advantage HMO-POS Elements (HMO-POS) - H5883-001-5 Benefit Details |
Oakland | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,600 | ||||||
CareSource Advantage (HMO SNP) - H0141-001-0 Benefit Details |
Oakland | $ 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 | |||||
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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 | |||||||||
Fidelis Secure Comfort (HMO SNP) - H2323-005-0 Benefit Details |
Oakland | $34.30 | $320 | 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 | |||||
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Fidelis Secure Freedom (HMO SNP) - H2323-011-0 Benefit Details |
Oakland | $34.30 | $320 | 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 | |||||
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Fidelis Secure Liberty (HMO SNP) - H2323-012-0 Benefit Details |
Oakland | $ 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 | |||||
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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 | |||||||||
Health Plan of Michigan Gold Plan (HMO SNP) - H5475-001-0 Benefit Details |
Oakland | $ 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% Tier 2: 0% | n/a Browse Formulary | |||||
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Midwest Advantage (HMO SNP) - H5685-001-0 Benefit Details |
Oakland | $ 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: $0.00 | n/a Browse Formulary | |||||
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UnitedHealthcare Dual Complete (HMO SNP) - H6952-002-0 Benefit Details |
Oakland | $ 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% Tier 2: 0% | n/a 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 | |||||||||
PriorityMedicare Value (HMO-POS) - H2320-021-0 Benefit Details |
Oakland | $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 | |||||
HAP Senior Plus - Henry Ford (HMO) - H2312-006-0 Benefit Details |
Oakland | $55.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice R5826-072 (Regional PPO) - R5826-072-0 Benefit Details |
Oakland | $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 | |||||||||
HAP Senior Plus - Henry Ford (HMO) - H2312-004-0 Benefit Details |
Oakland | $69.00 | $50 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: 31% Tier 5: 31% | $3,400 Browse Formulary | |||||
HealthPlus MedicarePlus-AdvantageHMO-POS Option 1 (HMO-POS) - H2354-001-0 Benefit Details |
Oakland | $75.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $39.00 Tier 3: $74.00 Tier 4: 25% | $3,400 Browse Formulary | |||||
Molina Medicare Options (HMO) - H5926-002-0 Benefit Details |
Oakland | $75.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 33% | $3,000 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 | |||||||||
Medicare Plus Blue PPO Vitality (PPO) - H9572-002-6 Benefit Details |
Oakland | $78.00 | $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 | |||||
HealthPlus MedicarePlus-AdvantagePPO Basic (PPO) - H1595-001-0 Benefit Details |
Oakland | $94.70 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $39.00 Tier 3: $74.00 Tier 4: 25% | $3,400 Browse Formulary | |||||
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HAP Senior Plus - Expanded Network (HMO-POS) - H2312-008-0 Benefit Details |
Oakland | $95.00 | 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 | |||||||||
HumanaChoice R5826-006 (Regional PPO) - R5826-006-0 Benefit Details |
Oakland | $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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Fidelis Secure Comfort Plus (HMO SNP) - H2323-006-0 Benefit Details |
Oakland | $98.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $65.00 Tier 4: 33% | n/a Browse Formulary | |||||
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BCN Advantage HMO-POS Classic (HMO-POS) - H5883-002-7 Benefit Details |
Oakland | $103.00 | $0 | Many Generics | Tier 1: $3.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 25% Tier 5: 30% | $4,400 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 | |||||||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-007-0 Benefit Details |
Oakland | $105.00 | $25 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: 32% Tier 5: 32% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Henry Ford (HMO) - H2312-009-0 Benefit Details |
Oakland | $108.00 | $100 | All Generics | Tier 1: $4.00 Tier 2: $10.00 Tier 3: $40.00 Tier 4: 30% Tier 5: 30% | $3,400 Browse Formulary | |||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-6 Benefit Details |
Oakland | $118.00 | $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 | |||||
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 |
Oakland | $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 | |||||
HealthPlus MedicarePlus-AdvantageHMO-POS Option 2 (HMO-POS) - H2354-013-0 Benefit Details |
Oakland | $121.00 | $0 | All Generics | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 25% | $3,400 Browse Formulary | |||||
HealthPlus MedicarePlus-AdvantagePPO Enhanced (PPO) - H1595-002-0 Benefit Details |
Oakland | $132.00 | $0 | All Generics | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 25% | $3,400 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 | |||||||||
PriorityMedicare Select (PPO) - H4875-015-0 Benefit Details |
Oakland | $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 | |||||
Fidelis Secure Independence (HMO SNP) - H2323-007-0 Benefit Details |
Oakland | $149.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $65.00 Tier 4: 33% | n/a Browse Formulary | |||||
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Alliance Medicare PPO (PPO) - H2322-001-0 Benefit Details |
Oakland | $152.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $10.00 Tier 3: $45.00 Tier 4: 33% Tier 5: 33% | $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 | |||||||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-010-0 Benefit Details |
Oakland | $158.00 | $50 | All Generics | Tier 1: $4.00 Tier 2: $10.00 Tier 3: $40.00 Tier 4: 31% Tier 5: 31% | $3,400 Browse Formulary | |||||
Alliance Medicare PPO (PPO) - H2322-004-0 Benefit Details |
Oakland | $177.00 | $0 | All Generics | Tier 1: $4.00 Tier 2: $8.00 Tier 3: $40.00 Tier 4: 33% Tier 5: 33% | $6,700 Browse Formulary | |||||
BCN Advantage HMO-POS Prestige (HMO-POS) - H5883-003-5 Benefit Details |
Oakland | $200.00 | $0 | Many Generics | Tier 1: $3.00 Tier 2: $35.00 Tier 3: $75.00 Tier 4: 25% Tier 5: 30% | $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 | |||||||||
Medicare Plus Blue PPO Assure (PPO) - H9572-003-6 Benefit Details |
Oakland | $222.00 | $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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