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 |
|||||||||
AARP MedicareComplete SecureHorizons (HMO) - H4590-010-0 Benefit Details |
Wilson | $0.00 | $0 | Some Generics | Tier 1: $5.00 Tier 2: $33.00 Tier 3: $42.00 Tier 4: $82.00 Tier 5: 33% | $3,900 Browse Formulary | |||||
AARP MedicareComplete SecureHorizons Essential (HMO) - H4590-029-0 Benefit Details |
Wilson | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,900 | ||||||
Care Improvement Plus Gold Rx (PPO SNP) - H0084-004-0 Benefit Details |
Wilson | $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 | |||||
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 Gold Rx (Regional PPO SNP) - R6801-009-0 Benefit Details |
Wilson | $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 Plus H4510-015 (HMO) - H4510-015-0 Benefit Details |
Wilson | $0.00 | $0 | Some Generics, Few Brands | Tier 1: $0.00 Tier 2: $20.00 Tier 3: $60.00 Tier 4: 33% | $4,000 Browse Formulary | |||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Wilson | $0.00 | 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 |
|||||
Service | Exper. | Cost Info | |||||||||
UnitedHealthcare Chronic Complete (HMO SNP) - H4590-037-0 Benefit Details |
Wilson | $0.00 | $0 | Some Generics | Tier 1: $5.00 Tier 2: $32.00 Tier 3: $42.00 Tier 4: $82.00 Tier 5: 33% | n/a Browse Formulary | |||||
UnitedHealthcare Dual Complete (HMO SNP) - H4590-022-0 Benefit Details |
Wilson | $ 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 | |||||
Care Improvement Plus Medicare Advantage (PPO) - H0084-001-0 Benefit Details |
Wilson | $15.00 | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Plus SNP-DE H4510-024 (HMO SNP) - H4510-024-0 Benefit Details |
Wilson | $ 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 | |||||
UnitedHealthcare Nursing Home Plan (HMO SNP) - H4590-039-0 Benefit Details |
Wilson | $28.50 | $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% | n/a Browse Formulary | |||||
Care Improvement Plus Dual Advantage (PPO SNP) - H0084-005-0 Benefit Details |
Wilson | $ 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: 28% | 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 | |||||||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R6801-011-0 Benefit Details |
Wilson | $ 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 | |||||
Care Improvement Plus Silver Rx (PPO SNP) - H0084-003-0 Benefit Details |
Wilson | $30.00 | $210 | 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 | |||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R6801-008-0 Benefit Details |
Wilson | $30.00 | $165 | 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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HumanaChoice H4520-006 (PPO) - H4520-006-0 Benefit Details |
Wilson | $49.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Wilson | $54.00 | $0 | Few Generics, Few Brands | Tier 1: $7.00 Tier 2: $42.00 Tier 3: $82.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
-- | |||||||||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Wilson | $59.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $9.00 Tier 2: $45.00 Tier 3: $95.00 Tier 4: 33% | $6,700 Browse Formulary | |||||
|