2014 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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AARP MedicareComplete (HMO) - H0303-015-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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AARP MedicareComplete Plus (HMO-POS) - H0316-002-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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Blue Medicare Advantage Classic (HMO) - H0302-006-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | Few Generics | Preferred Generic: $4.00 Non-Preferred Generic: $14.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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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 | |||||||||
Cigna Medicare Select Plus Rx-Diabetes Heart (HMO SNP) - H0354-021-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | Many Generics | Preferred Generic: $2.00 Non-Preferred Generic: $9.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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Higher cost-sharing at standard network pharmacies. Details:
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Cigna Medicare Select Plus Rx-Standard (HMO) - H0354-001-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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Higher cost-sharing at standard network pharmacies. Details:
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Health Net Green (HMO) - H0351-030-0 Benefit Details ![]() ![]() ![]() |
Pinal | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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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 | |||||||||
Health Net Jade (HMO SNP) - H0351-038-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | n/a Browse Formulary | |||||
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Health Net Jade Cardiovascular (HMO SNP) - H0351-042-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | n/a Browse Formulary | |||||
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Health Net Ruby 4 (HMO) - H0351-036-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $6,700 Browse Formulary | |||||
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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 | |||||||||
Health Net Ruby Select (HMO) - H0351-040-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $15.00 Preferred Brand: $44.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $3,400 Browse Formulary | |||||
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Humana Gold Plus H2649-031 (HMO) - H2649-031-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal (Partial) | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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Humana Gold Plus H2649-032 (HMO) - H2649-032-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | Few 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 | |||||
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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 R5826-070 P (Regional PPO) - R5826-070-0 Benefit Details ![]() ![]() ![]() |
Pinal | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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HumanaChoice R5826-070 P (Regional PPO) - R5826-070-0 Benefit Details ![]() ![]() ![]() |
Pinal (Partial) | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
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Phoenix Advantage (HMO) - H5985-001-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
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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 | |||||||||
Blue Medicare Advantage Plus (HMO) - H0302-001-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $17.00 | $0 | Few Generics | Preferred Generic: $3.00 Non-Preferred Generic: $13.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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UnitedHealthcare Dual Complete (HMO SNP) - H0321-002-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $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 | |||||
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Complete Care Advantage (HMO SNP) - H9768-001-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $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 | |||||
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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 | |||||||||
Health Choice Generations (HMO SNP) - H5587-002-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $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% | n/a Browse Formulary | |||||
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UnitedHealthcare Nursing Home Plan (PPO SNP) - H0319-001-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $27.50 | $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% | n/a Browse Formulary | |||||
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Phoenix Advantage Select (HMO) - H5985-005-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $39.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Specialty Tier: 33% | $3,500 Browse Formulary | |||||
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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 | |||||||||
Health Net Ruby 1 (HMO) - H0351-043-1 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $49.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $5,300 Browse Formulary | |||||
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Humana Gold Plus H2649-041 (HMO) - H2649-041-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal (Partial) | $52.00 | $0 | Few 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 | |||||
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Blue Medicare Advantage Premier (HMO) - H0302-007-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $55.00 | $0 | Few Generics | Preferred Generic: $2.00 Non-Preferred Generic: $12.00 Preferred Brand: $30.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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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 Plus H2649-030 (HMO-POS) - H2649-030-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $79.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
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HumanaChoice H0317-004 (PPO) - H0317-004-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $125.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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HumanaChoice R5826-014 P (Regional PPO) - R5826-014-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $152.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 28% | $6,700 Browse Formulary | |||||
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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 R5826-014 P (Regional PPO) - R5826-014-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal (Partial) | $152.00 | $175 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 28% | $6,700 Browse Formulary | |||||
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Humana Gold Choice H8145-103 (PFFS) - H8145-103-0 Benefit Details ![]() ![]() ![]() ![]() |
Pinal | $180.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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