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 |
|||||||||
Any, Any, Any Gold (PFFS) - H8098-001-0 Benefit Details |
Washington | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $15.00 Tier 3: $45.00 Tier 4: $85.00 Tier 5: 33% | $6,700 Browse Formulary | |||||
-- | -- | ||||||||||
Any, Any, Any Gold MA Only (PFFS) - H8098-003-0 Benefit Details |
Washington | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
-- | -- | ||||||||||
Sierra Spectrum (PPO) - H2905-001-0 Benefit Details |
Washington | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd | $5,900 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 Plus (HMO SNP) - H5628-001-0 Benefit Details |
Washington | $ 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 | |||||
Regence MedAdvantage Basic (PPO) - H4605-001-0 Benefit Details |
Washington | $48.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
WindsorSterling Gold Plus Plan (PPO) - H8558-004-0 Benefit Details |
Washington | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $16.00 Tier 3: $36.00 Tier 4: $90.00 Tier 5: 30% | $4,000 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) - H5628-002-0 Benefit Details |
Washington | $68.00 | $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% | $3,400 Browse Formulary | |||||
Regence MedAdvantage + Rx Classic (PPO) - H4605-002-0 Benefit Details |
Washington | $93.00 | $190 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $7.50 Tier 2: $33.00 Tier 3: $45.00 Tier 4: $90.00 Tier 5: 28% Tier 6: 28% | $3,400 Browse Formulary | |||||
Regence MedAdvantage + Rx Enhanced (PPO) - H4605-004-0 Benefit Details |
Washington | $163.00 | $0 | Many Generics | Tier 1: $5.00 Tier 2: $33.00 Tier 3: $45.00 Tier 4: $90.00 Tier 5: 33% Tier 6: 33% | $2,500 Browse Formulary | |||||
|