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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Anthem Medicare Preferred Core (PPO) - H1517-004-0 Benefit Details |
Barton | $0.00 | $60 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $0.00 | $4,500 Browse Formulary | |||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R3444-009-0 Benefit Details |
Barton | $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 Choice H8145-120 (PFFS) - H8145-120-0 Benefit Details |
Barton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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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 R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Barton | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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Advantra Freedom (PPO) - H5509-010-0 Benefit Details |
Barton | $19.70 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
Mercy MedicareADVANTAGE (PPO) - H2611-018-0 Benefit Details |
Barton | $22.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $75.00 Tier 4: 33% | $3,900 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 | |||||||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R3444-008-0 Benefit Details |
Barton | $31.80 | $150 | 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 Dual Advantage (Regional PPO SNP) - R3444-011-0 Benefit Details |
Barton | $ 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: $45.00 Tier 3: $95.00 Tier 4: 27% | n/a Browse Formulary | |||||
Humana Gold Choice H8145-125 (PFFS) - H8145-125-0 Benefit Details |
Barton | $33.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 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 | |||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R3444-012-0 Benefit Details |
Barton | $60.00 | $215 | 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 | |||||
Today's Options Premier 400 (PFFS) - H6169-015-0 Benefit Details |
Barton | $84.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Barton | $105.00 | $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 200 (PFFS) - H6169-052-0 Benefit Details |
Barton | $120.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,250 | ||||||
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Today's Options Premier Plus 450C (PFFS) - H6169-035-0 Benefit Details |
Barton | $121.00 | $35 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $6,700 Browse Formulary | |||||
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Today's Options Premier Plus 250A (PFFS) - H6169-056-0 Benefit Details |
Barton | $187.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $3,250 Browse Formulary | |||||
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