2013 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
Fallon Senior Plan Saver (HMO) - H9001-029-1 Benefit Details |
Essex | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Fallon Senior Plan Super Saver Rx (HMO) - H9001-032-1 Benefit Details |
Essex | $0.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Preferred Brand: $32.00 Non-Preferred Brand: $76.00 Specialty Tier: 25% | $3,400 Browse Formulary | |||||
Tufts Medicare Preferred HMO Saver Rx (HMO) - H2256-028-0 Benefit Details |
Essex | $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% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
AARP MedicareComplete Choice (Regional PPO) - R7444-001-0 Benefit Details |
Essex | $20.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Tufts Medicare Preferred HMO Basic (HMO) - H2256-027-1 Benefit Details |
Essex | $20.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
UnitedHealthcare Senior Care Options (HMO SNP) - H2226-001-0 Benefit Details |
Essex | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medicare HMO Blue ValueRx (HMO) - H2261-019-0 Benefit Details |
Essex | $28.00 | $220 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 27% | $3,400 Browse Formulary | |||||
Erickson Advantage Guardian (HMO-POS SNP) - H5652-003-0 Benefit Details |
Essex | $28.30 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
UnitedHealthcare Nursing Home Plan (PPO SNP) - H2228-001-0 Benefit Details |
Essex | $30.40 | $325 | 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 | |||||
-- | |||||||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
NaviCare (HMO SNP) - H9001-019-0 Benefit Details |
Essex | $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% | n/a Browse Formulary | |||||
Senior Care Options Program (HMO SNP) - H2225-001-0 Benefit Details |
Essex | $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 | |||||
Senior Whole Health (HMO SNP) - H2224-001-0 Benefit Details |
Essex | $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 | Generic: 25% Brand: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Tufts Medicare Preferred HMO Basic Rx (HMO) - H2256-026-1 Benefit Details |
Essex | $44.80 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $33.00 Non-Preferred Brand: $93.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Erickson Advantage Freedom (HMO-POS) - H5652-006-0 Benefit Details |
Essex | $48.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Fallon Senior Plan Saver Enhanced RX (HMO) - H9001-030-1 Benefit Details |
Essex | $52.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Preferred Brand: $27.00 Non-Preferred Brand: $76.00 | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medicare PPO Blue ValueRx (PPO) - H2230-016-0 Benefit Details |
Essex | $66.10 | $220 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 27% | $3,400 Browse Formulary | |||||
Tufts Medicare Preferred HMO Value (HMO) - H2256-019-1 Benefit Details |
Essex | $103.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Tufts Medicare Preferred HMO Value Rx (HMO) - H2256-018-1 Benefit Details |
Essex | $131.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $33.00 Non-Preferred Brand: $93.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Erickson Advantage Signature without Drugs (HMO-POS) - H5652-002-0 Benefit Details |
Essex | $136.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 | ||||||
Tufts Medicare Preferred HMO Prime (HMO) - H2256-016-1 Benefit Details |
Essex | $136.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Medicare PPO Blue PlusRx (PPO) - H2230-002-0 Benefit Details |
Essex | $136.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Fallon Senior Plan Plus Enhanced RX (HMO) - H9001-031-1 Benefit Details |
Essex | $153.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Preferred Brand: $27.00 Non-Preferred Brand: $76.00 | $3,400 Browse Formulary | |||||
Tufts Medicare Preferred HMO Prime Rx (HMO) - H2256-015-1 Benefit Details |
Essex | $164.10 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $33.00 Non-Preferred Brand: $93.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Erickson Advantage Champion (HMO-POS SNP) - H5652-004-0 Benefit Details |
Essex | $176.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
Erickson Advantage Signature with Drugs (HMO-POS) - H5652-001-0 Benefit Details |
Essex | $176.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
Medicare HMO Blue PlusRx (HMO) - H2261-005-0 Benefit Details |
Essex | $183.00 | $120 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
Tufts Medicare Preferred HMO Prime Rx Plus (HMO) - H2256-001-1 Benefit Details |
Essex | $196.90 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
|