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 R5826-069 (Regional PPO) - R5826-069-0 Benefit Details |
Payne | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Lovelace Medicare Plan Value (HMO) - H6801-002-0 Benefit Details |
Payne | $12.30 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $32.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $3,500 Browse Formulary | |||||
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Lovelace Medicare Plan Value Plus (HMO) - H6801-004-0 Benefit Details |
Payne | $101.10 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $3,500 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 | |||||||||
HumanaChoice R5826-013 (Regional PPO) - R5826-013-0 Benefit Details |
Payne | $164.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
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