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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Preferred Gold without Part D (HMO-POS) - H9859-001-0 Benefit Details |
Addison | $18.40 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
BasiCare with Part D (PPO) - H9615-008-0 Benefit Details |
Addison | $27.00 | $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% | $4,000 Browse Formulary | |||||
AARP MedicareComplete Choice (Regional PPO) - R7444-001-0 Benefit Details |
Addison | $30.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $8.00 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 |
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Service | Exper. | Cost Info | |||||||||
Today's Options Premier 900 (PFFS) - H3333-039-0 Benefit Details |
Addison | $58.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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GoldValue with Part D (HMO-POS) - H9859-013-0 Benefit Details |
Addison | $59.50 | $0 | Few Generics | Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $6,000 Browse Formulary | |||||
GoldAnywhere with Part D - Option 2 (PPO) - H9615-007-0 Benefit Details |
Addison | $64.00 | $0 | Few Generics | Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $4,000 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 | |||||||||
Today's Options Premier Plus 950G (PFFS) - H3333-057-0 Benefit Details |
Addison | $104.00 | $130 | 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 | |||||
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Today's Options Premier 600 (PFFS) - H3333-164-0 Benefit Details |
Addison | $105.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a | ||||||
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Preferred Gold with Part D (HMO-POS) - H9859-002-0 Benefit Details |
Addison | $117.00 | $0 | Few Generics | Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $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 | |||||||||
Today's Options Premier Plus 350A (PFFS) - H3333-166-0 Benefit Details |
Addison | $188.00 | $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 | |||||
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GoldAnywhere with Part D - Option 1 (PPO) - H9615-002-0 Benefit Details |
Addison | $238.00 | $0 | Few Generics | Preferred Generic: $8.00 Preferred Brand: $35.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $2,000 Browse Formulary | |||||
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