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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PacificSource Medicare Explorer 12 (PPO) - H4754-012-0 Benefit Details |
Bonner | $10.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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PacificSource Medicare Essentials Rx 20 (HMO) - H3864-020-0 Benefit Details |
Bonner | $25.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Preferred Brand: $44.00 Non-Preferred Brand: $88.00 Specialty Tier: 33% | $3,000 Browse Formulary | |||||
True Blue (HMO) - H1350-006-0 Benefit Details |
Bonner | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
Humana Gold Plus H2012-030 (HMO-POS) - H2012-030-0 Benefit Details |
Bonner | $36.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $39.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
Secure Blue (PPO) - H1302-004-0 Benefit Details |
Bonner | $40.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
PacificSource Medicare Explorer Rx 11 (PPO) - H4754-011-0 Benefit Details |
Bonner | $45.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Preferred Brand: $44.00 Non-Preferred Brand: $88.00 Specialty Tier: 33% | $3,000 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 | |||||||||
Regence MedAdvantage Basic (PPO) - H1304-001-0 Benefit Details |
Bonner | $64.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Secure Blue (PPO) - H1302-001-0 Benefit Details |
Bonner | $93.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $43.00 Non-Preferred Brand: $93.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Regence MedAdvantage + Rx Classic (PPO) - H1304-002-0 Benefit Details |
Bonner | $98.00 | $165 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.50 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 29% Injectable Drugs: 29% | $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 | |||||||||
True Blue Rx Option II (HMO) - H1350-010-0 Benefit Details |
Bonner | $121.00 | $300 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Brand: $70.00 Specialty Tier: 25% | $3,000 Browse Formulary | |||||
True Blue Rx Option I (HMO) - H1350-001-0 Benefit Details |
Bonner | $142.00 | $0 | Many Generics | Generic: $6.00 Preferred Brand: $31.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $3,000 Browse Formulary | |||||
True Blue Special Needs Plan (HMO SNP) - H1350-009-0 Benefit Details |
Bonner | $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 | |||||
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 | |||||||||
Regence MedAdvantage + Rx Enhanced (PPO) - H1304-004-0 Benefit Details |
Bonner | $188.00 | $0 | Many Generics | Preferred Generic: $5.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Injectable Drugs: 33% | $2,500 Browse Formulary | |||||
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