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 SecureHorizons Plan 2 (HMO) - H0543-147-0 Benefit Details |
Stanislaus | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $7.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,900 Browse Formulary | |||||
Care1st AdvantageOptimum Plan (HMO) - H5928-022-0 Benefit Details |
Stanislaus | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $50.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
Citizens Choice Healthplan (HMO) - H3815-006-0 Benefit Details |
Stanislaus | $0.00 | $0 | Many Generics | Generic: $0.00 Preferred Brand: $15.00 Non-Preferred Brand: $60.00 Injectable Drugs: 25% 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 | |||||||||
Easy Choice Best Plan (HMO) - H5087-005-0 Benefit Details |
Stanislaus | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
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Kaiser Permanente Senior Advantage Basic Stanis (HMO) - H0524-041-0 Benefit Details |
Stanislaus | $0.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $65.00 Specialty Tier: 25% Vaccines: $0.00 | $3,400 Browse Formulary | |||||
StartSmart with CareMore (HMO) - H0544-021-0 Benefit Details |
Stanislaus | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $10.00 | $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 | |||||||||
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) - H0524-030-0 Benefit Details |
Stanislaus | $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 | Preferred Generic: $10.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
Health Net Seniority Plus Amber II (HMO SNP) - H0562-070-0 Benefit Details |
Stanislaus | $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 | |||||
Easy Choice Plus Plan (HMO) - H5087-002-0 Benefit Details |
Stanislaus | $29.90 | $325 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Non-Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | $6,700 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 | |||||||||
CareMore Value Plus (HMO) - H0544-027-0 Benefit Details |
Stanislaus | $49.00 | $0 | All Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% Select Care Drugs: $10.00 | $3,400 Browse Formulary | |||||
CareMore Breathe (HMO SNP) - H0544-031-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% Select Care Drugs: $0.00 | n/a Browse Formulary | |||||
CareMore Diabetes (HMO SNP) - H0544-032-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% Select Care Drugs: $0.00 | 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 | |||||||||
CareMore Heart (HMO SNP) - H0544-036-0 Benefit Details |
Stanislaus | $59.00 | $0 | All Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% Select Care Drugs: $0.00 | n/a Browse Formulary | |||||
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO) - H0524-040-0 Benefit Details |
Stanislaus | $63.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $65.00 Specialty Tier: 25% Vaccines: $0.00 | $3,400 Browse Formulary | |||||
AARP MedicareComplete SecureHorizons Plan 1 (HMO) - H0543-036-0 Benefit Details |
Stanislaus | $89.00 | $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% | $4,900 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 | |||||||||
Health Net Seniority Plus Green (HMO) - H0562-045-0 Benefit Details |
Stanislaus | $99.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Health Net Healthy Heart (HMO) - H0562-053-0 Benefit Details |
Stanislaus | $135.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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