2014 St. Mary Parish, LA Medicare Advantage Plans

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Selected County:* St. Mary, Louisiana

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Other Options: Only plans with MOOP ≤ $3,400 5-star rated plans Limit search to 10 plans

LIS Subsidy Amount: none
LIS 100%   LIS 75%
LIS 50%   LIS 25%

Maximum Premium:
$ max: $344

Maximum Deductible:
$ max: $310

Health Coverage Type:

Special Needs Plans (SNP) Options: Only show SNPs (All 3 Types)
OR only: Dual-Eligible
Chronic Condition
Institutional

Max. Copay Tier 1 (Generics):
$
tip: enter 0 to show plans with a $0 Tier 1 copay

Prescription Drug Coverage:

Type of Gap Coverage:

Additional Info:

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Link to This Chart

**There are 9 Louisiana 2014 Medicare Advantage plans (MAPD) meeting your criteria.**

**Caution:** The **2014** Medicare Advantage plan information below is for research purposes.
**Click here to see 2025 Medicare Advantage plans**
2014 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
HumanaChoice R5826-068 (Regional PPO) - R5826-068-0 Benefit Details	St. Mary	$0.00	No Rx Coverage	This Plan does NOT include Prescription Drug coverage.	$3,400

UnitedHealthcare MedicareDirect Essential (PFFS) - H5435-001-0 Benefit Details	St. Mary	$0.00	No Rx Coverage	This Plan does NOT include Prescription Drug coverage.	n/a

UnitedHealthcare MedicareDirect Rx (PFFS) - H5435-024-0 Benefit Details	St. Mary	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $44.00 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
Service	Exper.	Cost Info
Peoples Health Secure Choice (HMO SNP) - H1961-008-0 Benefit Details	St. Mary	$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: 15% Tier 2: 15% Tier 3: 15% Tier 4: 15% Tier 5: 15%	n/a Browse Formulary

HumanaChoice H7002-002 (PPO) - H7002-002-0 Benefit Details	St. Mary	$39.00	$0	Few Generics, Few Brands	Preferred Generic: $5.00 Non-Preferred Generic: $12.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33%	$6,700 Browse Formulary

HumanaChoice R5826-078 (Regional PPO) - R5826-078-0 Benefit Details	St. Mary	$44.00	$310	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25%	$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
Humana Gold Choice H1906-001 (PFFS) - H1906-001-0 Benefit Details	St. Mary	$51.00	$0	Few Generics, Few Brands	Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33%	n/a Browse Formulary

HumanaChoice R5826-011 (Regional PPO) - R5826-011-0 Benefit Details	St. Mary	$74.00	$100	Few Generics, Few Brands	Preferred Generic: $5.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 30%	$6,700 Browse Formulary

Peoples Health Choices Select (HMO) - H1961-007-0 Benefit Details	St. Mary	$116.00	$0	All Generics, Few Brands	Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $55.00 Specialty Tier: 20%	$6,700 Browse Formulary

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Chart Legend:

Below are a few notes to help with the understanding of the 2014 Medicare Advantage Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

A few notes to help with the understanding of the 2014 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)

CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.

This is a 1 to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor.

Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.

This category includes measures of how drug plans rate on the following areas:
- Time on Hold When Customer and Pharmacist Calls Drug Plan.
- Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
- Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
- Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.

Member Plan Exper. - Member Experience with Drug Plan - This category shows how well drug plans make prescription drugs available to their members.

This category includes measures of how drug plans rate on the following areas:
- Drug Plan Provides Information or Help When Members Need It.
- Members’ Overall Rating of Drug Plan.
- Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.

RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.

This category includes measures of how drug plans rate on the following areas:
- Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
- Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
- Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
- Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
- Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.

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County: Medicare Advantage Plans are only available in specific county and in some cases on in part of a county. This field will note the county where the plan is available or in some cases, "Statewide" if the plan is available in every county. (Search Tip: You must enter your 5 digit ZIP Code in the criteria field to begin your search. We will determine your county from your ZIP code and only show appropriate plans.)
Monthly Premium: This is the amount you must pay each month to use the plan. For the Medicare Advantage Plans shown above, this premium includes Medicare Part C AND Part D (if the plan has prescription drug coverage). This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)
Deductible: This is the $310 deductible that was presented in the CMS Standard Plan. Many provider’s plans do not have a deductible, however the premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible field" field.)

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Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3605 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2014, ALL formulary generics will have at least a 28% discount and ALL brand drugs will have at least a 52.5% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
- No Rx Cov.: This plan does not include prescription drug coverage. You are 100% responsible for your medication costs. If you would like to see ONLY those plans that do include some type of prescription coverage, please select ":Show only plans WITH Drug Coverage" in the "Prescription Drug Coverage" selector above (this is the default setting);
- No Gap Coverage: you must pay the $3605;
- All Generics and All Brands: All formulary generics and all formulary Brand drugs are covered through the donut hole. This gap coverage option is available in Los Angeles and Orange counties in CA on the CareMore Value Plus (HMO) plan and in Dade county, FL on the Medica HealthCare Plans MedicareMax(PSO) plan;
- All Generics and Some Brands: All formulary generics and a some (10% to 65%) of formulary Brands are covered through the donut hole; Plans available in Riverside, CA, Many counties in LA, and Washoe, NV.
- All Generics and Few Brands: All formulary generics and a few (less than 10%) of formulary Brands are covered through the donut hole; Plans available in Los Angeles, Orange and San Bernadino, CA and many counties in NY.
- All Generics: All formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3605;
- Many Generics and Some Brands: Many formulary generics (65% to 100%) and a some (10% to 65%) formulary Brands are covered through the donut hole;
- Many Generics and Few Brands: Many formulary generics (65% to 100%) and a few (less than 10%) formulary Brands are covered through the donut hole;
- Many Generics: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3605;
- Some Generics and Few Brands: Some formulary generics (10% to 65%) and a few (less than 10%) formulary Brands are covered through the donut hole;
- Some Generics: 10% to 65% of formulary generics are covered, but you must pay for Brand Drugs up to $3605;
- Few Generics and Few Brands: Less than 10% of formulary generics and a few (less than 10%) formulary Brands are covered through the donut hole;
- Few Generics: Less than 10% of formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3605;
Plan ID: This is the unique id for this particular plan.

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Copay / Coinsurance - Cost Sharing - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)

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Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)

Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.
Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.
Members in This County (December 2014 figures) - This is the total number of members in this plan's service area (a "plan" is a specific contract ID and plan ID, for example H1234-001) Generally speaking, this service area is a county, but could include multiple counties. We are showing the latest Medicare Advantage plan enrollment figures. We update this figure as new enrollment statistics are released by Medicare.

MOOP for Part A & B Benefits - MOOP is the Maximum Out-of-Pocket limit set by the Medicare Advantage Plan. The figure shown is the beneficiaries yearly maximum out of pocket cost-sharing expenditure (co-payments / co-insurance) for Medicare Parts A & B (NOT Part D - prescription drug cost-sharing) . N/A That this plan does not actually offer health cost-sharing benefits. Example: a Medicare Savings Account (MSA).
Health Plan Type - This the organization type for the Medicare Advantage Plan. This could be Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), etc. (Search Tip: If you would like to limit your search to a specific type of Medicare Advantage Plans, please select the health plan type in the "Type of Health Coverage" field.);
SNP Eligibility Requirements - Special Needs Plans (SNPs) have an eligibility requirement whereas all other Medicare Advantage plans do not. (Search Tip: If you would like to limit your search to specific types of Special Needs Medicare Advantage Plans, please check the appropriate boxes in the "Special Needs Plans (SNP) Options" field.)

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(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the Medicare.gov website plan finder.)

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information.

2014 Medicare Advantage Plans: SNPs, Health (MAs), Health & Rx Drug (MA-PDs)

2014 Medicare Advantage Plans: SNPs,
Health (MAs), Health & Rx Drug (MA-PDs)