2014 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
ActiveSaver MSA (MSA) - H9788-003-0 Benefit Details |
Schuyler | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Medicare BlueClassic PPO (PPO) - H3335-037-0 Benefit Details |
Schuyler | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
Today's Options Premier 400 (PFFS) - H2816-007-0 Benefit Details |
Schuyler | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,400 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
UnitedHealthcare MedicareComplete Choice (Regional PPO) - R5342-001-0 Benefit Details |
Schuyler | $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% | $5,200 Browse Formulary | |||||
UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Benefit Details |
Schuyler | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,200 | ||||||
HumanaChoice H5970-001 (PPO) - H5970-001-0 Benefit Details |
Schuyler | $24.00 | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Today's Options Premier Plus 850B (PFFS) - H2816-019-0 Benefit Details |
Schuyler | $37.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | n/a Browse Formulary | |||||
Today's Options Premier 100 (PFFS) - H2816-001-0 Benefit Details |
Schuyler | $40.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Medicare BlueBasic PPO (PPO) - H3335-042-0 Benefit Details |
Schuyler | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,800 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H1291-001 (PFFS) - H1291-001-0 Benefit Details |
Schuyler | $72.00 | $0 | Few Generics, Few Brands | Preferred Generic: $9.00 Non-Preferred Generic: $18.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
-- | -- | ||||||||||
Medicare BlueSecure PPO (PPO) - H3335-008-0 Benefit Details |
Schuyler | $77.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
Today's Options Premier Plus 350A (PFFS) - H2816-013-0 Benefit Details |
Schuyler | $92.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medicare BlueEnhanced PPO (PPO) - H3335-009-0 Benefit Details |
Schuyler | $118.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,000 Browse Formulary | |||||
HumanaChoice H5970-004 (PPO) - H5970-004-0 Benefit Details |
Schuyler | $152.00 | $200 | Few Generics, Few Brands | Preferred Generic: $8.00 Non-Preferred Generic: $18.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 27% | $6,700 Browse Formulary | |||||
|