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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Humana Gold Choice H8145-050 (PFFS) - H8145-050-0 Benefit Details |
Summers | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-062 (Regional PPO) - R5826-062-0 Benefit Details |
Summers | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Freedom Blue PPO HD (PPO) - H5106-026-0 Benefit Details |
Summers | $13.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 29% | $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 H8145-051 (PFFS) - H8145-051-0 Benefit Details |
Summers | $56.00 | $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 | |||||
HumanaChoice R5826-081 (Regional PPO) - R5826-081-0 Benefit Details |
Summers | $75.00 | $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 | |||||
Humana Gold Choice H8145-049 (PFFS) - H8145-049-0 Benefit Details |
Summers | $82.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $14.00 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 | |||||||||
HumanaChoice R5826-002 (Regional PPO) - R5826-002-0 Benefit Details |
Summers | $85.00 | $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% | $5,300 Browse Formulary | |||||
Freedom Blue PPO Value (PPO) - H5106-018-0 Benefit Details |
Summers | $104.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
Freedom Blue PPO Standard (PPO) - H5106-015-0 Benefit Details |
Summers | $185.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $4,000 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 | |||||||||
Freedom Blue PPO Deluxe (PPO) - H5106-016-0 Benefit Details |
Summers | $263.00 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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