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 Plus (HMO-POS) - H3887-003-0 Benefit Details |
Cook | $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% | $4,900 Browse Formulary | |||||
Aetna Medicare Value Plan (HMO) - H1419-001-0 Benefit Details |
Cook | $0.00 | $0 | Few Generics | Generic: $10.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 33% Select Care Drugs: $0.00 | $6,700 Browse Formulary | |||||
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Blue Cross Medicare Advantage Basic (HMO) - H3822-001-0 Benefit Details |
Cook | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $2.00 Preferred Brand: $39.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 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 | |||||||||
Blue Cross Medicare Advantage Basic Plus (HMO-POS) - H3822-007-0 Benefit Details |
Cook | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $2.00 Preferred Brand: $39.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,800 Browse Formulary | |||||
-- | -- | -- | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Cigna-HealthSpring Advantage (HMO) - H1415-013-0 Benefit Details |
Cook | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Cigna-HealthSpring Premier (HMO-POS) - H1415-021-0 Benefit Details |
Cook | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $75.00 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 | |||||||||
Community Care Alliance of Illinois (HMO) - H3071-002-0 Benefit Details |
Cook | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $5.00 Brand: 25% | $3,400 Browse Formulary | |||||
new | new | new | |||||||||
Humana Gold Plus H1406-013 (HMO) - H1406-013-0 Benefit Details |
Cook | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HumanaChoice R5826-023 P (Regional PPO) - R5826-023-0 Benefit Details |
Cook | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
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 | |||||||||
WellCare Rx (HMO) - H1416-019-0 Benefit Details |
Cook | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 Specialty Tier: 33% | $3,900 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
WellCare Value (HMO-POS) - H1416-009-0 Benefit Details |
Cook | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $13.00 Preferred Brand: $35.00 Non-Preferred Brand: $69.00 Specialty Tier: 33% | $4,000 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
WellCare Access (HMO SNP) - H1416-007-0 Benefit Details |
Cook | $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: $9.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 Specialty Tier: 25% | n/a 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 | |||||||||
Cigna-HealthSpring Primary (HMO) - H1415-024-0 Benefit Details |
Cook | $23.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% | $3,400 Browse Formulary | |||||
Cigna-HealthSpring TotalCare (HMO SNP) - H1415-005-0 Benefit Details |
Cook | $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 | |||||
UnitedHealthcare Nursing Home Plan (HMO-POS SNP) - H3887-001-0 Benefit Details |
Cook | $26.80 | $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 | |||||
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 | |||||||||
Molina Medicare Options Plus (HMO SNP) - H8870-001-0 Benefit Details |
Cook | $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 | |||||
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Humana Gold Choice H8145-121 (PFFS) - H8145-121-0 Benefit Details |
Cook | $29.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Blue Cross Medicare Advantage Premier Plus (HMO-POS) - H3822-008-0 Benefit Details |
Cook | $38.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $2.00 Preferred Brand: $39.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,500 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 | |||||||||
Aetna Medicare Standard Plan (PPO) - H5521-016-0 Benefit Details |
Cook | $101.00 | $0 | Few Generics | Generic: $10.00 Preferred Brand: 25% Non-Preferred Brand: 50% Specialty Tier: 33% Select Care Drugs: $0.00 | $5,000 Browse Formulary | |||||
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HumanaChoice H1418-002 (PPO) - H1418-002-0 Benefit Details |
Cook | $110.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
HumanaChoice R5826-009 P (Regional PPO) - R5826-009-0 Benefit Details |
Cook | $112.00 | $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 |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-008 (PFFS) - H8145-008-0 Benefit Details |
Cook | $152.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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