2013 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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AARP MedicareComplete Choice Essential (Regional PPO) - R5287-002-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,500 | ||||||
AARP MedicareComplete Choice Plan 2 (Regional PPO) - R5287-001-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,900 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) - R3332-001-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,900 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 | |||||||||
HealthSpring Advantage (HMO) - H5410-004-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HealthSpring Preferred (HMO) - H5410-005-0 Benefit Details |
Escambia | $0.00 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Humana Gold Plus H1036-143 (HMO) - H1036-143-0 Benefit Details |
Escambia | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $3,400 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 | |||||||||
Humana Gold Plus SNP-DB H1036-194 (HMO SNP) - H1036-194-0 Benefit Details |
Escambia | $0.00 | $0 | Some Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Humana Reader's Digest Healthy Living Plan (Regional PPO) - R5826-074-0 Benefit Details |
Escambia | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,950 Browse Formulary | |||||
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
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 | |||||||||
WellCare Advance (HMO) - H1032-037-0 Benefit Details |
Escambia | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
WellCare Value (HMO) - H1032-079-0 Benefit Details |
Escambia | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $3.00 Preferred Brand: $39.00 Non-Preferred Brand: $79.00 Specialty Tier: 33% | $6,000 Browse Formulary | |||||
WellCare Liberty (HMO SNP) - H1032-124-0 Benefit Details |
ESCAMBIA | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a 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 | |||||||||
WellCare Access (HMO SNP) - H1032-175-0 Benefit Details |
ESCAMBIA | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
WellCare Select (HMO-POS SNP) - H1032-101-0 Benefit Details |
ESCAMBIA | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
UnitedHealthcare Nursing Home Plan (PPO SNP) - H5417-001-0 Benefit Details |
Escambia | $23.80 | $325 | 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 | |||||
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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 | |||||||||
HealthSpring TotalCare (HMO SNP) - H5410-013-0 Benefit Details |
ESCAMBIA | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Tier 1: 25% | n/a Browse Formulary | |||||
Humana Gold Plus SNP-DE H1036-195 (HMO SNP) - H1036-195-0 Benefit Details |
ESCAMBIA | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
UnitedHealthcare Dual Complete RP (Regional PPO SNP) - R5287-003-0 Benefit Details |
Statewide | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | n/a | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | n/a 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 | |||||||||
HealthSpring Premier (HMO-POS) - H5410-012-0 Benefit Details |
Escambia | $39.50 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $2,950 Browse Formulary | |||||
WellCare Choice (HMO-POS) - H1032-025-0 Benefit Details |
Escambia | $54.60 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $3.00 Preferred Brand: $39.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,000 Browse Formulary | |||||
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0 Benefit Details |
Escambia | $85.00 | $0 | Few Generics, Few Brands | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $4,750 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 | |||||||||
Humana Gold Choice H8145-061 (PFFS) - H8145-061-0 Benefit Details |
Escambia | $102.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
BlueMedicare PPO (PPO) - H5434-002-0 Benefit Details |
Escambia | $152.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $17.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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