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 (HMO) - H0401-002-0 Benefit Details |
Crawford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,950 Browse Formulary | |||||
Advantra Premier Plus (PPO) - H2611-008-0 Benefit Details |
Crawford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $4,800 Browse Formulary | |||||
Advantra Total Care (HMO) - H2672-010-0 Benefit Details |
Crawford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 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 | |||||||||
AR Blue Cross - Medi-Pak Advantage MA (PFFS) - H4213-001-0 Benefit Details |
Crawford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
AR Blue Cross - Medi-Pak Advantage MA-PD Option 1 (PFFS) - H4213-004-0 Benefit Details |
Crawford | $0.00 | $170 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $11.00 Preferred Brand: 25% Non-Preferred Brand: 42% Specialty Tier: 25% | n/a Browse Formulary | |||||
AR Blue Cross -Medi-Pak Advantage Platinum (PFFS) - H4213-010-0 Benefit Details |
Crawford | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $11.00 Preferred Brand: 25% Non-Preferred Brand: 42% 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 | |||||||||
Care Improvement Plus Copper RX (Regional PPO SNP) - R3444-022-0 Benefit Details |
Crawford | $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 (Regional PPO SNP) - R3444-009-0 Benefit Details |
Crawford | $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 (Regional PPO) - R3444-012-0 Benefit Details |
Crawford | $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 | |||||||||
Humana Gold Choice H8145-120 (PFFS) - H8145-120-0 Benefit Details |
Crawford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Humana Gold Plus H2012-001 (HMO) - H2012-001-0 Benefit Details |
Crawford | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $4,000 Browse Formulary | |||||
HumanaChoice R5826-067 (Regional PPO) - R5826-067-0 Benefit Details |
Crawford | $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 |
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Service | Exper. | Cost Info | |||||||||
Windsor Medicare Extra Emerald Plan (HMO) - H5698-063-0 Benefit Details |
Crawford | $0.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $44.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Windsor Medicare Extra Silver Plan (HMO) - H5698-035-0 Benefit Details |
Crawford | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Arkansas Community Care - Plus (HMO) - H6972-001-0 Benefit Details |
Crawford | $18.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $11.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,950 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 | |||||||||
Windsor Medicare Extra Comp Plus Plan (HMO SNP) - H5698-128-0 Benefit Details |
Crawford | $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% Tier 5: 25% | n/a Browse Formulary | |||||
Humana Gold Plus SNP-DE H2012-081 (HMO SNP) - H2012-081-0 Benefit Details |
Crawford | $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% Tier 5: 25% | n/a Browse Formulary | |||||
Care Improvement Plus Chrome RX (Regional PPO SNP) - R3444-021-0 Benefit Details |
Crawford | $34.40 | $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 (Regional PPO SNP) - R3444-011-0 Benefit Details |
Crawford | $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 (Regional PPO SNP) - R3444-008-0 Benefit Details |
Crawford | $34.40 | $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 | |||||
Windsor Medicare Extra Gold Plan (HMO) - H5698-020-0 Benefit Details |
Crawford | $40.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $43.00 Non-Preferred Brand: $67.00 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 | |||||||||
HumanaChoice H7188-006 (PPO) - H7188-006-0 Benefit Details |
Crawford | $48.00 | $325 | Few Generics | Preferred Generic: $1.00 Non-Preferred Generic: $3.00 Preferred Brand: 19% Non-Preferred Brand: 30% Specialty Tier: 25% | $5,500 Browse Formulary | |||||
Windsor Medicare Extra Fusion Plan (HMO SNP) - H5698-129-0 Benefit Details |
Crawford | $63.00 | $0 | Some Generics | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
HumanaChoice H7188-003 (PPO) - H7188-003-0 Benefit Details |
Crawford | $71.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $11.00 Preferred Brand: $43.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $5,000 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 H8145-122 (PFFS) - H8145-122-0 Benefit Details |
Crawford | $79.00 | $0 | Few Generics, Few Brands | Preferred Generic: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Windsor Medicare Extra Diabetes Plan (HMO SNP) - H5698-154-0 Benefit Details |
Crawford | $103.00 | $0 | Some Generics | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
HumanaChoice R5826-010 (Regional PPO) - R5826-010-0 Benefit Details |
Crawford | $114.00 | $325 | 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 | |||||
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 | |||||||||
Windsor Medicare Extra Diamond Plan (HMO) - H5698-069-0 Benefit Details |
Crawford | $138.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $65.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
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