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 Plan 2 (HMO) - H4456-010-0 Benefit Details |
Peoria | $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% | $4,500 Browse Formulary | |||||
Care Improvement Plus Copper RX (PPO SNP) - H0084-030-0 Benefit Details |
Peoria | $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 (PPO SNP) - H0084-007-0 Benefit Details |
Peoria | $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 | |||||
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 Medicare Advantage (PPO) - H0084-009-0 Benefit Details |
Peoria | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,900 Browse Formulary | |||||
Coventry Total Care (HMO) - H3144-002-0 Benefit Details |
Peoria | $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% | $3,200 Browse Formulary | |||||
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Health Alliance Medicare HMO Basic (HMO-POS) - H1463-008-0 Benefit Details |
Peoria | $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 | |||||||||
HumanaChoice R5826-023 (Regional PPO) - R5826-023-0 Benefit Details |
Peoria | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
Today's Options Premier 600 (PFFS) - H6169-011-0 Benefit Details |
Peoria | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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WellCare Value (HMO-POS) - H1416-009-0 Benefit Details |
Peoria | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $3.00 Preferred Brand: $39.00 Non-Preferred Brand: $69.00 Specialty Tier: 33% | $3,900 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 | |||||||||
WellCare Access (HMO SNP) - H1416-007-0 Benefit Details |
Peoria | $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: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
Advantra (PPO) - H7301-002-0 Benefit Details |
Peoria | $18.00 | $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% | $3,200 Browse Formulary | |||||
Humana Gold Choice H8145-121 (PFFS) - H8145-121-0 Benefit Details |
Peoria | $19.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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 | |||||||||
Today's Options Premier 300 (PFFS) - H6169-001-0 Benefit Details |
Peoria | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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Advantra (HMO) - H3144-003-0 Benefit Details |
Peoria | $21.50 | $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% | $6,700 Browse Formulary | |||||
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WellCare Rx (HMO) - H1416-019-0 Benefit Details |
Peoria | $25.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $3.00 Preferred Brand: $39.00 Non-Preferred Brand: $69.00 Specialty Tier: 33% | $3,000 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 | |||||||||
Care Improvement Plus Chrome RX (PPO SNP) - H0084-029-0 Benefit Details |
Peoria | $30.90 | $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 | |||||
Care Improvement Plus Silver Rx (PPO SNP) - H0084-006-0 Benefit Details |
Peoria | $30.90 | $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 | |||||
Today's Options Premier Plus 650B (PFFS) - H6169-031-0 Benefit Details |
Peoria | $32.00 | $0 | 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 | |||||
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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 | |||||||||
Health Alliance Medicare HMO Basic Rx (HMO-POS) - H1463-009-0 Benefit Details |
Peoria | $34.00 | $150 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | $3,400 Browse Formulary | |||||
Health Alliance Medicare PPO30 (PPO) - H1417-003-0 Benefit Details |
Peoria | $35.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Humana Gold Plus H1468-007 (HMO) - H1468-007-0 Benefit Details |
Peoria | $62.00 | $0 | Few Generics, Few Brands | Preferred Generic: $5.00 Preferred Brand: $36.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $4,500 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 Alliance Medicare PPO30 Rx (PPO) - H1417-004-0 Benefit Details |
Peoria | $69.00 | $180 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 28% | $3,000 Browse Formulary | |||||
Health Alliance Medicare HMO20 (HMO) - H1463-001-0 Benefit Details |
Peoria | $75.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $1,500 | ||||||
Today's Options Premier Plus 350A (PFFS) - H6169-021-0 Benefit Details |
Peoria | $77.00 | $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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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 | |||||||||
AARP MedicareComplete Plan 1 (HMO) - H4456-015-0 Benefit Details |
Peoria | $85.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $6.00 Preferred Brand: $38.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,900 Browse Formulary | |||||
HumanaChoice R5826-009 (Regional PPO) - R5826-009-0 Benefit Details |
Peoria | $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 | |||||
HumanaChoice H5525-004 (PPO) - H5525-004-0 Benefit Details |
Peoria | $92.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 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 | |||||||||
Health Alliance Medicare PPO10 (PPO) - H1417-001-0 Benefit Details |
Peoria | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $1,500 | ||||||
Health Alliance Medicare HMO20 Rx (HMO) - H1463-003-0 Benefit Details |
Peoria | $119.00 | $130 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | $1,500 Browse Formulary | |||||
Humana Gold Choice H8145-008 (PFFS) - H8145-008-0 Benefit Details |
Peoria | $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 | |||||
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 Alliance Medicare PPO10 Rx (PPO) - H1417-002-0 Benefit Details |
Peoria | $144.00 | $140 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | $1,500 Browse Formulary | |||||
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