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 |
|||||||||
AARP MedicareComplete Plan 3 (HMO) - H5005-019-0 Benefit Details |
Cowlitz | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $7.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice H6609-070 (PPO) - H6609-070-0 Benefit Details |
Cowlitz | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
Community HealthFirst MA Special Needs Plan (HMO SNP) - H5826-005-0 Benefit Details |
Cowlitz | $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% | 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 | |||||||||
Kaiser Permanente Senior Advantage Basic (HMO) - H9003-006-0 Benefit Details |
Cowlitz | $39.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 25% Tier 6: $0.00 | $4,900 Browse Formulary | |||||
AARP MedicareComplete Plan 1 (HMO) - H5005-011-0 Benefit Details |
Cowlitz | $73.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $6.00 Preferred Brand: $44.00 Non-Preferred Brand: $88.00 Specialty Tier: 33% | $4,200 Browse Formulary | |||||
Community HealthFirst MA Pharmacy Plan (HMO) - H5826-009-0 Benefit Details |
Cowlitz | $77.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Preferred Brand: $50.00 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 | |||||||||
HumanaChoice H6609-062 (PPO) - H6609-062-0 Benefit Details |
Cowlitz | $86.00 | $0 | Few Generics, Few Brands | Preferred Generic: $4.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,900 Browse Formulary | |||||
Regence MedAdvantage Basic (PPO) - H5009-001-0 Benefit Details |
Cowlitz | $89.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Kaiser Permanente Senior Advantage (HMO) - H9003-001-0 Benefit Details |
Cowlitz | $109.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 25% Tier 6: $0.00 | $2,500 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible | Additional Gap Coverage | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Regence MedAdvantage + Rx Classic (PPO) - H5009-002-0 Benefit Details |
Cowlitz | $137.00 | $235 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 26% | $3,400 Browse Formulary | |||||
HumanaChoice H6609-073 (PPO) - H6609-073-0 Benefit Details |
Cowlitz | $205.00 | $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 | |||||
|