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 SecureHorizons Essential (HMO) - H0543-121-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,900 | ||||||
AARP MedicareComplete SecureHorizons Plan 4 (HMO) - H0543-152-0 Benefit Details |
San Diego | $0.00 | $0 | Some Generics | Preferred Generic: $5.00 Non-Preferred Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Aetna Medicare Select Plan (HMO) - H0523-052-0 Benefit Details |
San Diego | $0.00 | $0 | Few Generics | Generic: $10.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 33% Select Care Drugs: $0.00 | $4,900 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 | |||||||||
Blue Shield 65 Plus (HMO) - H0504-028-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Preferred Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Injectable Drugs: 25% Specialty Tier: 33% | $3,000 Browse Formulary | |||||
Care1st AdvantageOptimum Plan (HMO) - H5928-010-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $7.00 Preferred Brand: $35.00 Non-Preferred Brand: $60.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
Easy Choice Best Plan (HMO) - H5087-012-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics | 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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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 Healthy Heart (HMO) - H0562-012-0 Benefit Details |
San Diego | $0.00 | $0 | Many Generics, Few Brands | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $5,000 Browse Formulary | |||||
Health Net Seniority Plus Green (HMO) - H0562-044-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Humana Gold Plus H0108-008 (HMO) - H0108-008-0 Benefit Details |
San Diego | $0.00 | $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 |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Plus H0108-029 (HMO) - H0108-029-0 Benefit Details |
San Diego | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Kaiser Permanente Senior Advantage San Diego (HMO) - H0524-037-0 Benefit Details |
San Diego | $0.00 | $0 | All Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Vaccines: $0.00 | $5,900 Browse Formulary | |||||
SCAN Classic (HMO) - H5425-005-0 Benefit Details |
San Diego | $0.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% Select Care Drugs: $10.00 | $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 | |||||||||
Sharp SecureHorizons Plan by UnitedHealthcare (HMO) - H0543-145-0 Benefit Details |
San Diego | $0.00 | $0 | Some Generics | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,700 Browse Formulary | |||||
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) - H0524-029-0 Benefit Details |
San Diego | $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: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Vaccines: $0.00 | n/a Browse Formulary | |||||
Molina Medicare Options Plus (HMO SNP) - H5810-001-0 Benefit Details |
San Diego | $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 | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 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 | |||||||||
AARP MedicareComplete SecureHorizons Value (HMO) - H0543-013-0 Benefit Details |
San Diego | $25.00 | $0 | Some Generics | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,300 Browse Formulary | |||||
SCAN Plus (HMO) - H5425-040-0 Benefit Details |
San Diego | $25.40 | $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% Tier 6: 25% | $6,700 Browse Formulary | |||||
Coordinated Choice Plan (HMO) - H5928-037-0 Benefit Details |
San Diego | $26.30 | $310 | Few Generics | Preferred Generic: $0.00 Non-Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | $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 | |||||||||
Care1st TotalDual Plan (HMO SNP) - H5928-009-0 Benefit Details |
San Diego | $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 | |||||
CommuniCare Advantage (HMO SNP) - H7086-001-0 Benefit Details |
San Diego | $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 | Generic: $0.00 Brand: $60.00 | n/a Browse Formulary | |||||
Easy Choice Plus Plan (HMO) - H5087-002-0 Benefit Details |
San Diego | $28.10 | $310 | Call plan for details | Preferred Generic: $0.00 Non-Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | $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 Seniority Plus Amber II (HMO SNP) - H0562-070-0 Benefit Details |
San Diego | $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: $0.00 Non-Preferred Generic: $13.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Select Care Drugs: $0.00 | n/a Browse Formulary | |||||
Humana Gold Plus H0108-009 (HMO-POS) - H0108-009-0 Benefit Details |
San Diego | $42.00 | $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% | $5,000 Browse Formulary | |||||
AARP MedicareComplete SecureHorizons Premier (HMO) - H0543-060-0 Benefit Details |
San Diego | $69.00 | $0 | Some Generics | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $42.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,300 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 | |||||||||
SCAN Signature (HMO) - H5425-004-0 Benefit Details |
San Diego | $70.00 | $0 | Many Generics | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% Select Care Drugs: $10.00 | $4,000 Browse Formulary | |||||
Health Net Violet (PPO) - H5439-001-0 Benefit Details |
San Diego | $92.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $25.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $3,400 Browse Formulary | |||||
Anthem Medicare Preferred Standard (PPO) - H8552-006-0 Benefit Details |
San Diego | $106.00 | $173 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $16.00 Preferred Brand: $36.00 Non-Preferred Brand: $80.00 Injectable Drugs: $95.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
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 Seniority Plus Ruby (HMO) - H0562-040-0 Benefit Details |
San Diego | $129.00 | $0 | Many Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $5,000 Browse Formulary | |||||
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