AARP MedicareComplete Choice Essential (Regional PPO) - R5287-002-0
Benefit Details
|
Broward |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
|
|
|
|
AARP MedicareComplete Choice Plan 2 (Regional PPO) - R5287-001-0
Benefit Details
|
Broward |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
|
Aetna Medicare Value Plan (HMO) - H5414-019-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: 50% 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 |
Amerivantage Classic + Rx (HMO) - H8991-028-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $15.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00
| $6,700 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Amerivantage Specialty + Rx (HMO SNP) - H8991-017-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00 Select Care Drugs: $0.00
| $6,700 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
AvMed Medicare Choice (HMO) - H1016-021-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $7.00 Preferred Brand: $35.00 Non-Preferred Brand: $70.00 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 |
Service |
Exper. |
Cost Info |
BlueMedicare HMO LifeTime (HMO) - H1026-040-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $2.00 Non-Preferred Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33%
| $4,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
BlueMedicare HMO MyTime (HMO) - H1026-055-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Specialty Tier: 33%
| $3,650 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
CareDirect (HMO SNP) - H1019-032-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $50.00 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 |
Service |
Exper. |
Cost Info |
CareHeart (HMO SNP) - H1019-062-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $15.00 Non-Preferred Brand: $45.00 Specialty Tier: 33%
| $5,000 Browse Formulary |
|
|
|
|
CareOne (HMO) - H1019-001-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $5,000 Browse Formulary |
|
|
|
|
Clear Skies (HMO SNP) - H4199-015-0
Sanctioned Plan
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 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 |
Service |
Exper. |
Cost Info |
Coventry Summit Ideal (HMO) - H1013-031-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $10.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Coventry Vista Ideal (HMO) - H1013-021-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $4,800 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Day Break (HMO) - H4199-013-0
Sanctioned Plan
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $45.00 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 |
Service |
Exper. |
Cost Info |
Freedom Medicare Plan Rx (HMO) - H5427-060-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $85.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
|
Freedom VIP Savings (HMO SNP) - H5427-082-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
-- |
|
|
|
Freedom VIP Savings COPD (HMO SNP) - H5427-083-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 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 |
HealthSun HealthAdvantage Plan (HMO) - H5431-012-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $15.00 Non-Preferred Brand: $30.00 Specialty Tier: 33% Supplemental Brand and Generic Drugs: $0.00
| $3,400 Browse Formulary |
-- |
-- |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Humana Gold Plus - Diabetes (HMO SNP) - H1036-121-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $5,000 Browse Formulary |
|
|
|
|
Humana Gold Plus - Heart (HMO SNP) - H1036-186-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $50.00 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 |
Service |
Exper. |
Cost Info |
Humana Gold Plus H1036-053A (HMO) - H1036-053-0
Benefit Details
|
Broward |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 |
|
|
|
|
Humana Gold Plus H1036-065C (HMO) - H1036-065-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $5,000 Browse Formulary |
|
|
|
|
Humana Gold Plus H1036-237 (HMO) - H1036-237-1
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 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 |
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0
Benefit Details
|
Broward |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 |
|
|
|
|
HumanaChoice R5826-074 (Regional PPO) - R5826-074-0
Benefit Details
|
Broward |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 28%
| $6,700 Browse Formulary |
|
|
|
|
Medica HealthCare Plans MedicareMax (HMO) - H5420-003-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $89.00 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 |
Optimum Gold Rewards Plan (HMO-POS) - H5594-001-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $80.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
|
Optimum Platinum Plan (HMO-POS) - H5594-002-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $10.00 Non-Preferred Brand: $69.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
|
PHP (HMO SNP) - H3132-001-0
Benefit Details
|
Broward |
$0.00 |
$320 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25%
| 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 |
Preferred Choice Broward (HMO) - H1045-005-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $40.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Sunrise (HMO) - H4199-012-0
Sanctioned Plan
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
-- |
|
|
WellCare Advance (HMO) - H1032-037-0
Benefit Details
|
Broward |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
WellCare Dividend (HMO) - H1032-179-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
WellCare Essential (HMO-POS) - H1032-133-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $79.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
WellCare Value (HMO) - H1032-073-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $79.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
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 |
Service |
Exper. |
Cost Info |
Humana Gold Plus SNP-DE H1036-103A (HMO SNP) - H1036-103-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
|
|
|
|
CareNeeds (HMO SNP) - H1019-023-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
|
|
|
|
WellCare Access (HMO SNP) - H1032-124-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $6,700 Browse Formulary |
|
|
|
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 |
Service |
Exper. |
Cost Info |
WellCare Liberty (HMO SNP) - H1032-175-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
WellCare Select (HMO SNP) - H1032-061-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Medica HealthCare Plans MedicareMax Plus (HMO-POS SNP) - H5420-006-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $500 Browse Formulary |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UnitedHealthcare Nursing Home Plan (PPO SNP) - H5417-001-0
Benefit Details
|
Broward |
$24.30 |
$320 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
| $6,700 Browse Formulary |
-- |
-- |
|
|
Preferred Medicare Assist (HMO-POS SNP) - H1045-012-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
|
|
|
|
Coventry Summit Maximum (HMO SNP) - H1013-030-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Options Plus (HMO SNP) - H8130-001-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $6,700 Browse Formulary |
-- |
-- |
|
|
Freedom Medi-Medi Full (HMO SNP) - H5427-087-0
Benefit Details
|
Broward |
$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: $0.00
| $3,400 Browse Formulary |
-- |
|
|
|
Freedom Medi-Medi Partial (HMO SNP) - H5427-078-0
Benefit Details
|
Broward |
$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: tbd
| $3,400 Browse Formulary |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HealthSun MediMax (HMO) - H5431-006-0
Benefit Details
|
Broward |
$25.80 |
$320 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Non-Preferred Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% Supplemental Brand and Generic Drugs: $0.00
| $3,400 Browse Formulary |
-- |
-- |
|
|
Optimum Emerald Full (HMO SNP) - H5594-017-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
-- |
|
|
|
Optimum Emerald Partial (HMO SNP) - H5594-016-0
Benefit Details
|
Broward |
$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 | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
-- |
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Sunny Days (HMO SNP) - H4199-016-0
Sanctioned Plan
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Specialty Tier: $0.00
| $3,400 Browse Formulary |
-- |
-- |
|
|
Sunshine Health Advantage (HMO SNP) - H5190-003-0
Benefit Details
|
Broward |
$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 | Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $0.00 Injectable Drugs: $0.00
| $3,400 Browse Formulary |
-- |
-- |
-- |
|
UnitedHealthcare Dual Complete RP (Regional PPO SNP) - R5287-003-0
Benefit Details
|
Broward |
$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: tbd
| $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 |
Aetna Medicare Premier Plan (PPO) - H5521-033-0
Benefit Details
|
Broward |
$35.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $3.00 Preferred Brand: $45.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
|
BlueMedicare Regional PPO (Regional PPO) - R3332-001-0
Benefit Details
|
Broward |
$36.10 |
$100 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $28.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 25%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice H5415-056 (PPO) - H5415-056-0
Benefit Details
|
Broward |
$43.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 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 |
Service |
Exper. |
Cost Info |
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0
Benefit Details
|
Broward |
$95.00 |
$100 |
Yes, some additional gap coverage. | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 30%
| $6,700 Browse Formulary |
|
|
|
|
Humana Gold Choice H8145-061 (PFFS) - H8145-061-0
Benefit Details
|
Broward |
$101.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
BlueMedicare PPO (PPO) - H5434-002-0
Benefit Details
|
Broward |
$127.10 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $2.00 Non-Preferred Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $75.00 Specialty Tier: 33%
| $3,200 Browse Formulary |
|
|
|
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 |
Service |
Exper. |
Cost Info |
Aetna Medicare Select Plus Plan (HMO) - H5414-025-0
Benefit Details
|
Broward |
$139.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $3.00 Preferred Brand: $45.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $3,300 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Select Plus Plan (PPO) - H5521-052-0
Benefit Details
|
Broward |
$139.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $3.00 Preferred Brand: $45.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $3,300 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|