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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HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
McHenry | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
Humana Gold Choice H8145-121 (PFFS) - H8145-121-0 Benefit Details |
McHenry | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Meridian Advantage Plan of Illinois (HMO SNP) - H5779-001-0 Benefit Details |
McHenry | $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% | n/a Browse Formulary | |||||
new | new | new | |||||||||
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 H1406-022 (HMO-POS) - H1406-022-0 Benefit Details |
McHenry | $59.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $41.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Today's Options Premier 600 (PFFS) - H5421-056-0 Benefit Details |
McHenry | $80.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
McHenry | $89.00 | $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 | |||||||||
HumanaChoice H1418-002 (PPO) - H1418-002-0 Benefit Details |
McHenry | $102.00 | $0 | Few Generics, Few Brands | Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Today's Options Premier 300 (PFFS) - H5421-210-0 Benefit Details |
McHenry | $115.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Today's Options Premier Plus 650D (PFFS) - H5421-074-0 Benefit Details |
McHenry | $118.00 | $85 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | 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 | |||||||||
Humana Gold Choice H8145-008 (PFFS) - H8145-008-0 Benefit Details |
McHenry | $132.00 | $0 | Few Generics, Few Brands | Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Today's Options Premier Plus 350A (PFFS) - H5421-068-0 Benefit Details |
McHenry | $175.00 | $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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