2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Care Improvement Plus Gold Rx (PPO SNP) - H0084-019-0 Benefit Details |
Eddy | $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 | |||||
Care Improvement Plus Silver Rx (PPO SNP) - H0084-018-0 Benefit Details |
Eddy | $21.30 | $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% | n/a Browse Formulary | |||||
Presbyterian MediCare PPO Plan 1 (PPO) - H3206-003-0 Benefit Details |
Eddy | $49.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Medicare Advantage (PPO) - H0084-021-0 Benefit Details |
Eddy | $53.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $10.00 Tier 2: $43.00 Tier 3: $95.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
Presbyterian MediCare PPO Plan 2 with Rx (PPO) - H3206-001-0 Benefit Details |
Eddy | $86.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $75.00 Tier 4: 30% | $3,400 Browse Formulary | |||||
Presbyterian MediCare PPO Plan 3 with Rx (PPO) - H3206-002-0 Benefit Details |
Eddy | $107.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $40.00 Tier 3: $75.00 Tier 4: 30% | $3,000 Browse Formulary | |||||
|