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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Care Improvement Plus Copper RX (PPO SNP) - H0084-027-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Copper RX (Regional PPO SNP) - R6801-022-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Gold Rx (PPO SNP) - H0084-004-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | 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 | |||||||||
Care Improvement Plus Gold Rx (Regional PPO SNP) - R6801-009-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (PPO) - H0084-001-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,400 Browse Formulary | |||||
Care Improvement Plus Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Bailey | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 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 | |||||||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Bailey | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Care Improvement Plus Chrome RX (PPO SNP) - H0084-026-0 Benefit Details |
Bailey | $31.80 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Care Improvement Plus Chrome RX (Regional PPO SNP) - R6801-021-0 Benefit Details |
Bailey | $31.80 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% 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 |
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Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Dual Advantage (PPO SNP) - H0084-005-0 Benefit Details |
Bailey | $0.00 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: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Care Improvement Plus Dual Advantage (Regional PPO SNP) - R6801-011-0 Benefit Details |
Bailey | $0.00 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: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
Care Improvement Plus Silver Rx (PPO SNP) - H0084-003-0 Benefit Details |
Bailey | $31.80 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% 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 |
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Service | Exper. | Cost Info | |||||||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R6801-008-0 Benefit Details |
Bailey | $31.80 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Bailey | $59.00 | $125 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $89.00 Specialty Tier: 30% | $6,700 Browse Formulary | |||||
Today's Options Premier 600 (PFFS) - H5421-057-0 Benefit Details |
Bailey | $90.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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 | |||||||||
Today's Options Premier Plus 650J (PFFS) - H5421-075-0 Benefit Details |
Bailey | $107.00 | $130 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $10.50 Preferred Brand: $45.00 Non-Preferred Brand: $75.00 Specialty Tier: 29% | n/a Browse Formulary | |||||
Today's Options Premier 300 (PFFS) - H5421-211-0 Benefit Details |
Bailey | $125.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Humana Gold Choice H2944-024 (PFFS) - H2944-024-0 Benefit Details |
Bailey | $129.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | 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 | |||||||||
Today's Options Premier Plus 350A (PFFS) - H5421-215-0 Benefit Details |
Bailey | $164.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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