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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Blue Cross Medicare Advantage Basic (HMO) - H3979-001-0 Benefit Details |
Grady | $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% | $4,500 Browse Formulary | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
Generations Healthcare Classic (HMO) - H3706-001-0 Benefit Details |
Grady | $0.00 | $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% | $3,300 Browse Formulary | |||||
Generations Healthcare Value (HMO) - H3706-009-0 Benefit Details |
Grady | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
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 | |||||||||
HumanaChoice R5826-069 (Regional PPO) - R5826-069-0 Benefit Details |
Grady | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Humana Gold Choice H8145-120 (PFFS) - H8145-120-0 Benefit Details |
Grady | $15.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
Blue Cross Medicare Advantage Premier Plus (HMO-POS) - H3979-002-0 Benefit Details |
Grady | $39.00 | $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% | $4,500 Browse Formulary | |||||
new | new | new | 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 | |||||||||
HumanaChoice H8644-005 (PPO) - H8644-005-0 Benefit Details |
Grady | $52.00 | $275 | Few Generics | Preferred Generic: $1.00 Non-Preferred Generic: $3.00 Preferred Brand: 15% Non-Preferred Brand: 30% Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
Blue Cross Medicare Advantage Choice (PPO) - H8634-001-0 Benefit Details |
Grady | $54.00 | $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 | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
HumanaChoice H8644-003 (PPO) - H8644-003-0 Benefit Details |
Grady | $68.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,000 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 | |||||||||
Humana Gold Choice H8145-001 (PFFS) - H8145-001-0 Benefit Details |
Grady | $162.00 | $125 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $12.00 Preferred Brand: $43.00 Non-Preferred Brand: $85.00 Specialty Tier: 29% | n/a Browse Formulary | |||||
HumanaChoice R5826-013 (Regional PPO) - R5826-013-0 Benefit Details |
Grady | $167.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | $3,400 Browse Formulary | |||||
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