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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Advantra (PPO) - H7306-001-0 Benefit Details |
Lubbock | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Amerivantage Classic+ Rx (HMO) - H5817-010-0 Benefit Details |
Lubbock | $0.00 | $0 | Some Generics | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Care Improvement Plus Copper RX (Regional PPO SNP) - R6801-022-0 Benefit Details |
Lubbock | $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 Gold Rx (Regional PPO SNP) - R6801-009-0 Benefit Details |
Lubbock | $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 Medicare Advantage (Regional PPO) - R6801-012-0 Benefit Details |
Lubbock | $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% | $6,700 Browse Formulary | |||||
FirstCare Advantage Silver (HMO) - H4525-005-0 Benefit Details |
Lubbock | $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 | |||||||||
HealthSpring Advantage (PPO) - H7787-002-0 Benefit Details |
Lubbock | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
HealthSpring Preferred (HMO) - H2165-018-0 Benefit Details |
Lubbock | $0.00 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-026 (Regional PPO) - R5826-026-0 Benefit Details |
Lubbock | $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 | |||||||||
Humana Gold Choice H8145-126 (PFFS) - H8145-126-0 Benefit Details |
Lubbock | $10.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Amerivantage Specialty + Rx (HMO SNP) - H5817-009-0 Benefit Details |
Lubbock | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Many Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | n/a Browse Formulary | |||||
Care Improvement Plus Chrome RX (Regional PPO SNP) - R6801-021-0 Benefit Details |
Lubbock | $31.80 | $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 | |||||
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 Dual Advantage (Regional PPO SNP) - R6801-011-0 Benefit Details |
Lubbock | $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 | |||||
Care Improvement Plus Silver Rx (Regional PPO SNP) - R6801-008-0 Benefit Details |
Lubbock | $31.80 | $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 | |||||
FirstCare Advantage Select (HMO SNP) - H4525-003-0 Benefit Details |
Lubbock | $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% | 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 | |||||||||
HealthSpring TotalCare (HMO SNP) - H2165-019-0 Benefit Details |
Lubbock | $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% | n/a Browse Formulary | |||||
HealthSpring Preferred (PPO) - H7787-001-0 Benefit Details |
Lubbock | $35.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $30.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
FirstCare Advantage Gold (HMO) - H4525-002-0 Benefit Details |
Lubbock | $39.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Preferred Brand: $45.00 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 |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-012 (Regional PPO) - R5826-012-0 Benefit Details |
Lubbock | $59.00 | $125 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $89.00 Specialty Tier: 30% | $6,700 Browse Formulary | |||||
Today's Options Premier 600 (PFFS) - H6169-015-0 Benefit Details |
Lubbock | $64.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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Humana Gold Choice H8145-084 (PFFS) - H8145-084-0 Benefit Details |
Lubbock | $87.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $39.00 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 | |||||||||
Today's Options Premier 300 (PFFS) - H6169-052-0 Benefit Details |
Lubbock | $100.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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Today's Options Premier Plus 650C (PFFS) - H6169-035-0 Benefit Details |
Lubbock | $106.00 | $75 | 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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FirstCare Advantage Elite (HMO) - H4525-009-0 Benefit Details |
Lubbock | $122.00 | $0 | Many Generics | Preferred Generic: $5.00 Preferred Brand: $45.00 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 |
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Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 350A (PFFS) - H6169-056-0 Benefit Details |
Lubbock | $172.00 | $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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