AARP MedicareComplete Choice Essential (Regional PPO) - R5287-002-0
Benefit Details
|
Miami-Dade |
$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
|
Miami-Dade |
$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
|
Miami-Dade |
$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 |
-- |
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|
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
|
Miami-Dade |
$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
|
Miami-Dade |
$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) - H1016-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $4,000 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) - H1026-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $25.00 Non-Preferred Brand: $50.00 Specialty Tier: 33%
| $3,200 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
CareDirect (HMO SNP) - H1019-075-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
CareFree PLUS (HMO) - H1019-076-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $45.00 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 |
CareHeart (HMO SNP) - H1019-063-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
CareOne PLUS (HMO) - H1019-006-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Clear Skies (HMO SNP) - H4199-005-0
Sanctioned Plan
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $25.00 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 Plus (HMO) - H1013-032-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $3,000 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Coventry Vista Ideal (HMO) - H1013-011-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: 50% Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Day Break (HMO) - H4199-002-0
Sanctioned Plan
|
Miami-Dade |
$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
|
Miami-Dade |
$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 Savings Plan (HMO) - H5427-052-0
Benefit Details
|
Miami-Dade |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 |
-- |
|
|
|
Freedom VIP Care (HMO SNP) - H5427-070-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $25.00 Non-Preferred Brand: $75.00 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 VIP Savings (HMO SNP) - H5427-072-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $80.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
|
Freedom VIP Savings COPD (HMO SNP) - H5427-077-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $80.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
|
|
|
HealthSun SunPlus Advantage Plan (HMO) - H5431-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
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: 33% Supplemental Brand and Generic Drugs: $0.00
| $3,400 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 |
HealthSun SunPlus Advantage POS (HMO-POS) - H5431-011-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
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: 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) - H1036-188-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Humana Gold Plus - Heart (HMO SNP) - H1036-189-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $35.00 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 |
Humana Gold Plus H1036-054C (HMO) - H1036-054-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Humana Gold Plus H1036-237 (HMO) - H1036-237-2
Benefit Details
|
Miami-Dade |
$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 |
|
|
|
|
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0
Benefit Details
|
Miami-Dade |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R5826-074 (Regional PPO) - R5826-074-0
Benefit Details
|
Miami-Dade |
$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 |
|
|
|
|
Leon Medical Centers Health Plans - Leon Cares (HMO) - H5410-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Brand: $0.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Medica HealthCare Plans MedicareMax (HMO) - H5420-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $25.00 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
|
Miami-Dade |
$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
|
Miami-Dade |
$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
|
Miami-Dade |
$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 Dade (HMO-POS) - H1045-001-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $25.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Preferred Complete Care (HMO) - H1045-016-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $25.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Preferred Special Care Miami-Dade (HMO SNP) - H1045-018-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $0.00 Non-Preferred Brand: $25.00 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 |
Simply Extra (HMO) - H5471-004-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Brand: $55.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Simply Level (HMO SNP) - H5471-012-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $15.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Simply More (HMO) - H5471-002-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $2.00 Non-Preferred Brand: $15.00 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 |
Sunrise (HMO) - H4199-001-0
Sanctioned Plan
|
Miami-Dade |
$0.00 |
$0 |
Yes, some additional gap coverage. | Generic: $0.00 Preferred Brand: $5.00 Non-Preferred Brand: $25.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
-- |
-- |
|
|
WellCare Dividend (HMO-POS) - H1032-040-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $25.00 Non-Preferred Brand: $49.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
WellCare Essential (HMO) - H1032-174-0
Benefit Details
|
Miami-Dade |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $20.00 Non-Preferred Brand: $60.00 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 |
CareNeeds (HMO SNP) - H1019-024-0
Benefit Details
|
Miami-Dade |
$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 |
|
|
|
|
Humana Gold Plus SNP-DE H1036-077A (HMO SNP) - H1036-077-0
Benefit Details
|
Miami-Dade |
$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 Select (HMO SNP) - H1032-061-0
Benefit Details
|
Miami-Dade |
$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 Access (HMO SNP) - H1032-170-0
Benefit Details
|
Miami-Dade |
$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
|
Miami-Dade |
$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 |
-- |
|
|
|
Preferred Medicare Assist (HMO-POS SNP) - H1045-012-0
Benefit Details
|
Miami-Dade |
$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 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Coventry Summit Maximum (HMO SNP) - H1013-030-0
Benefit Details
|
Miami-Dade |
$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 |
-- |
|
|
|
WellCare Liberty (HMO SNP) - H1032-176-0
Benefit Details
|
Miami-Dade |
$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:
|
Molina Medicare Options Plus (HMO SNP) - H8130-001-0
Benefit Details
|
Miami-Dade |
$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 |
-- |
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Coventry Vista Maximum (HMO SNP) - H1013-024-0
Benefit Details
|
Miami-Dade |
$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 Specialty Tier: $0.00
| $3,400 Browse Formulary |
-- |
|
|
|
Freedom Medi-Medi Full (HMO SNP) - H5427-087-0
Benefit Details
|
Miami-Dade |
$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
|
Miami-Dade |
$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
|
Miami-Dade |
$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
|
Miami-Dade |
$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
|
Miami-Dade |
$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 |
Simply Care (HMO SNP) - H5471-008-0
Benefit Details
|
Miami-Dade |
$25.80 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Simply Comfort (HMO SNP) - H5471-009-0
Benefit Details
|
Miami-Dade |
$25.80 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Non-Preferred Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Simply Complete (HMO SNP) - H5471-001-0
Benefit Details
|
Miami-Dade |
$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
| $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 |
Sunny Days (HMO SNP) - H4199-006-0
Sanctioned Plan
|
Miami-Dade |
$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) - H5190-004-0
Benefit Details
|
Miami-Dade |
$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 Injectable Drugs: $0.00
| $3,400 Browse Formulary |
-- |
-- |
-- |
|
UnitedHealthcare Dual Complete RP (Regional PPO SNP) - R5287-003-0
Benefit Details
|
Miami-Dade |
$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 |
UnitedHealthcare Nursing Home Plan (HMO SNP) - H5322-003-0
Benefit Details
|
Miami-Dade |
$31.60 |
$320 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
| $6,700 Browse Formulary |
-- |
-- |
-- |
|
Aetna Medicare Premier Plan (PPO) - H5521-033-0
Benefit Details
|
Miami-Dade |
$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
|
Miami-Dade |
$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:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5415-056 (PPO) - H5415-056-0
Benefit Details
|
Miami-Dade |
$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 |
-- |
|
|
|
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0
Benefit Details
|
Miami-Dade |
$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
|
Miami-Dade |
$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 |
|
|
|
|
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
|
Miami-Dade |
$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
|
Miami-Dade |
$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:
|