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 |
|||||||||
Anthem Senior Advantage Basic (HMO) - H3655-013-0 Benefit Details |
Union | $0.00 | $60 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $3,400 Browse Formulary | |||||
Anthem Senior Advantage Value (HMO) - H3655-031-0 Benefit Details |
Union | $0.00 | $60 | Many Generics | Tier 1: $0.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $0.00 | $3,400 Browse Formulary | |||||
Blue Medicare Access Classic (Regional PPO) - R5941-007-0 Benefit Details |
Union | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Blue Medicare Access Value (Regional PPO) - R5941-008-0 Benefit Details |
Union | $0.00 | $60 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $4,800 Browse Formulary | |||||
HumanaChoice R5826-021 (Regional PPO) - R5826-021-0 Benefit Details |
Union | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | |||||||||||
MediGold Essential Care (HMO) - H3668-011-0 Benefit Details |
Union | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $12.00 Tier 3: $45.00 Tier 4: $75.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Molina Medicare Options (HMO) - H0490-001-0 Benefit Details |
Union | $18.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $30.00 Tier 3: $60.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
-- | |||||||||||
Molina Medicare Options Plus (HMO SNP) - H0490-004-0 Benefit Details |
Union | $ 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 | |||||
-- | |||||||||||
CareSource Advantage (HMO SNP) - H6178-001-0 Benefit Details |
Union | $ 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 | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Anthem Senior Advantage Plus (HMO) - H3655-030-0 Benefit Details |
Union | $35.00 | $60 | Many Generics | Tier 1: $4.00 Tier 2: $40.00 Tier 3: $83.00 Tier 4: 33% Tier 5: 33% Tier 6: $4.00 | $3,000 Browse Formulary | |||||
Anthem Medicare Preferred Standard (PPO) - H5529-001-0 Benefit Details |
Union | $39.00 | $60 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $4,500 Browse Formulary | |||||
Humana Gold Choice H8145-135 (PFFS) - H8145-135-0 Benefit Details |
Union | $39.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | -- | ||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
MediGold Medical Only (HMO) - H3668-013-0 Benefit Details |
Union | $43.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HumanaChoice H3619-012 (PPO) - H3619-012-0 Benefit Details |
Union | $54.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $86.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
Anthem Medicare Preferred Select (PPO) - H5529-004-0 Benefit Details |
Union | $59.00 | $60 | Many Generics | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% Tier 5: 33% Tier 6: $7.00 | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-007 (Regional PPO) - R5826-007-0 Benefit Details |
Union | $74.00 | $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 | |||||
-- | |||||||||||
Humana Gold Choice H8145-032 (PFFS) - H8145-032-0 Benefit Details |
Union | $89.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $43.00 Tier 3: $85.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
-- | -- | ||||||||||
MediGold Classic Preferred (HMO) - H3668-005-0 Benefit Details |
Union | $97.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $10.00 Tier 3: $38.00 Tier 4: $50.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
MediGold Network Choice (PPO) - H1846-001-0 Benefit Details |
Union | $149.00 | $0 | Many Generics | Tier 1: $4.00 Tier 2: $12.00 Tier 3: $45.00 Tier 4: $75.00 Tier 5: 33% | $3,400 Browse Formulary | |||||
-- |
|