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 |
|||||||||
AARP MedicareComplete SecureHorizons (HMO) - H0543-085-0 Benefit Details |
San Francisco | $0.00 | $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 | |||||
CCHP Senior Plan B-only Plan (HMO) - H0571-002-0 Benefit Details |
SAN FRANCISCO | $0.00 | $325 | n/a | Generic: $10.00 Preferred Brand: $40.00 Specialty Tier: 20% | n/a Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) - H0524-030-0 Benefit Details |
San Francisco | $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: $10.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Vaccines: $0.00 | 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 | |||||||||
SCAN Plus (HMO) - H5425-041-0 Benefit Details |
San Francisco | $27.50 | $325 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% Select Care Drugs: $10.00 | $3,000 Browse Formulary | |||||
Care1st AdvantageOptimum Plan (HMO) - H5928-026-0 Benefit Details |
San Francisco | $28.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $50.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
CCHP Senior Select Program (HMO SNP) - H0571-005-0 Benefit Details |
San Francisco | $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% | 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 | |||||||||
Care1st TotalDual Plan (HMO SNP) - H5928-027-0 Benefit Details |
San Francisco | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Few Generics | Preferred Generic: $0.00 Non-Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | n/a Browse Formulary | |||||
Health Net Seniority Plus Amber II (HMO SNP) - H0562-070-0 Benefit Details |
San Francisco | $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 | |||||
Humana Gold Plus H0108-028 (HMO) - H0108-028-0 Benefit Details |
San Francisco | $32.00 | $0 | Few Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 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 |
|||||
Service | Exper. | Cost Info | |||||||||
CCHP Senior Program (HMO) - H0571-001-0 Benefit Details |
San Francisco | $45.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $40.00 Specialty Tier: 20% | $3,400 Browse Formulary | |||||
SCAN Classic (HMO) - H5425-019-0 Benefit Details |
San Francisco | $49.00 | $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: $75.00 Specialty Tier: 33% Select Care Drugs: $10.00 | $3,400 Browse Formulary | |||||
Humana Gold Plus H0108-027 (HMO) - H0108-027-0 Benefit Details |
San Francisco | $62.00 | $0 | Some Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 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 | |||||||||
Kaiser Permanente Senior Advantage Alam., SF, Napa (HMO) - H0524-032-0 Benefit Details |
San Francisco | $76.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $65.00 Specialty Tier: 25% Vaccines: $0.00 | $3,400 Browse Formulary | |||||
Anthem Medicare Preferred Standard (PPO) - H8552-008-0 Benefit Details |
San Francisco | $85.00 | $90 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Injectable Drugs: 33% Specialty Tier: 33% | $3,800 Browse Formulary | |||||
-- | -- | ||||||||||
Health Net Healthy Heart (HMO) - H0562-009-0 Benefit Details |
San Francisco | $89.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 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 | |||||||||
Health Net Seniority Plus Green (HMO) - H0562-045-0 Benefit Details |
San Francisco | $99.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
|