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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BCN Advantage HMO-POS Basic (HMO-POS) - H5883-004-4 Benefit Details |
St. Clair | $0.00 | $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% | $4,200 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantageHMO-POS Option 0 (HMO-POS) - H2354-015-0 Benefit Details |
St. Clair | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
HumanaChoice R5826-053 P (Regional PPO) - R5826-053-0 Benefit Details |
St. Clair | $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 | |||||||||
Medicare Plus Blue PPO Essential (PPO) - H9572-004-4 Benefit Details |
St. Clair | $17.50 | $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% | $6,400 Browse Formulary | |||||
BCN Advantage HMO-POS Elements (HMO-POS) - H5883-001-4 Benefit Details |
St. Clair | $25.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,600 | ||||||
HealthPlus MedicarePlus Advantage D-SNP (HMO SNP) - H2354-016-0 Benefit Details |
St. Clair | $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: 0% Tier 2: 0% Tier 3: 0% Tier 4: 0% | 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 | |||||||||
PriorityMedicare Value (HMO-POS) - H2320-011-0 Benefit Details |
St. Clair | $41.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantagePPO Basic (PPO) - H1595-003-0 Benefit Details |
St. Clair | $48.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,500 Browse Formulary | |||||
PriorityMedicare Merit (PPO) - H4875-016-5 Benefit Details |
St. Clair | $51.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $4,500 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 | |||||||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-012-0 Benefit Details |
St. Clair | $58.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: 33% Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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Medicare Plus Blue PPO Vitality (PPO) - H9572-002-4 Benefit Details |
St. Clair | $74.00 | $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% | $5,400 Browse Formulary | |||||
HumanaChoice R5826-006 P (Regional PPO) - R5826-006-0 Benefit Details |
St. Clair | $90.00 | $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 | |||||||||
BCN Advantage HMO-POS Classic (HMO-POS) - H5883-002-4 Benefit Details |
St. Clair | $95.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantageHMO-POS Option 1 (HMO-POS) - H2354-001-0 Benefit Details |
St. Clair | $98.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-007-0 Benefit Details |
St. Clair | $99.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: 30% Specialty Tier: 30% | $3,200 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 | |||||||||
PriorityMedicare (HMO-POS) - H2320-007-0 Benefit Details |
St. Clair | $101.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
PriorityMedicare Select (PPO) - H4875-017-2 Benefit Details |
St. Clair | $118.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Alliance Medicare PPO (PPO) - H2322-008-0 Benefit Details |
St. Clair | $124.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: 33% Specialty Tier: 33% | $3,401 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 | |||||||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-4 Benefit Details |
St. Clair | $146.00 | $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% | $4,400 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantageHMO-POS Option 2 (HMO-POS) - H2354-013-0 Benefit Details |
St. Clair | $150.00 | $0 | Many Generics | Generic: $6.00 Preferred Brand: $38.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantagePPO Enhanced (PPO) - H1595-002-0 Benefit Details |
St. Clair | $176.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $40.00 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 | |||||||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-010-0 Benefit Details |
St. Clair | $179.00 | $50 | All Generics | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: 31% Specialty Tier: 31% | $3,000 Browse Formulary | |||||
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Alliance Medicare PPO (PPO) - H2322-004-0 Benefit Details |
St. Clair | $203.00 | $150 | All Generics | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: 29% Specialty Tier: 29% | $3,401 Browse Formulary | |||||
Medicare Plus Blue PPO Assure (PPO) - H9572-003-4 Benefit Details |
St. Clair | $222.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 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 | |||||||||
BCN Advantage HMO-POS Prestige (HMO-POS) - H5883-003-4 Benefit Details |
St. Clair | $228.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $3,200 Browse Formulary | |||||
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