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 H6609-004 (PPO) - H6609-004-0 Benefit Details |
Sully | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
HumanaChoice H6609-019 (PPO) - H6609-019-0 Benefit Details |
Sully | $40.00 | $325 | Few Generics | Preferred Generic: $1.00 Non-Preferred Generic: $3.00 Preferred Brand: 17% Non-Preferred Brand: 30% Specialty Tier: 25% | $5,000 Browse Formulary | |||||
HumanaChoice H6609-001 (PPO) - H6609-001-0 Benefit Details |
Sully | $51.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $8.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 28% | $4,000 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 | |||||||||
Humana Gold Choice H8145-139 (PFFS) - H8145-139-0 Benefit Details |
Sully | $72.00 | $0 | Few Generics, Few Brands | Preferred Generic: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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