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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HumanaChoice R5826-023 P (Regional PPO) - R5826-023-0 Benefit Details |
Effingham | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
Health Alliance Medicare PPO30 (PPO) - H1417-003-0 Benefit Details |
Effingham | $40.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
Health Alliance Medicare PPO30 Rx (PPO) - H1417-004-0 Benefit Details |
Effingham | $73.00 | $230 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: tbd | $3,000 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 | |||||||||
Health Alliance Medicare PPO10 (PPO) - H1417-001-0 Benefit Details |
Effingham | $110.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $1,500 | ||||||
HumanaChoice R5826-009 P (Regional PPO) - R5826-009-0 Benefit Details |
Effingham | $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 | |||||
Health Alliance Medicare PPO10 Rx (PPO) - H1417-002-0 Benefit Details |
Effingham | $145.00 | $230 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: tbd | $1,500 Browse Formulary | |||||
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