AARP MedicareComplete Choice Essential (Regional PPO) - R7444-004-0
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) - R7444-003-0
Benefit Details
|
Broward |
$0.00 |
$230 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
| $6,700 Browse Formulary |
|
|
|
|
Aetna Medicare Premier Plan (PPO) - H5521-033-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 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 |
AvMed Medicare Choice (HMO) - H1016-021-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Drug: $75.00 Specialty Tier: 33%
| $5,000 Browse Formulary |
|
|
|
|
BlueMedicare HMO LifeTime (HMO) - H1026-040-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $13.00 Preferred Brand: $40.00 Non-Preferred Brand: $93.00 Specialty Tier: 33%
| $6,500 Browse Formulary |
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|
|
Higher cost-sharing at standard network pharmacies. Details:
|
BlueMedicare HMO MyTime Plus (HMO) - H1026-061-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 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 |
CareOne (HMO) - H1019-001-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $20.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Coventry Summit Ideal (HMO) - H1609-018-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $3.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
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: $40.00 Non-Preferred Drug: $85.00 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) - H5427-082-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Diabetic Drugs: $10.00
| n/a Browse Formulary |
|
|
|
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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: $40.00 Non-Preferred Drug: $90.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
Harmony Maximum (HMO) - H4627-006-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 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 |
HealthSun HealthAdvantage Plan (HMO) - H5431-012-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $15.00 Non-Preferred Drug: $30.00 Specialty Tier: 33% Supplemental Brand and Generic Drugs: $0.00
| $3,400 Browse Formulary |
|
-- |
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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 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
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 |
|
|
|
|
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 H1036-065C (HMO) - H1036-065-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $20.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Humana Gold Plus H1036-237 (HMO) - H1036-237-1
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice Florida H5415-075 (PPO) - H5415-075-0
Benefit Details
|
Broward |
$0.00 |
$250 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
| $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 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 |
$400 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Generic: $17.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Medica HealthCare Plans MedicareMax (HMO) - H5420-003-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $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) - H5594-001-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
Optimum Platinum Plan (HMO) - H5594-002-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Preferred Brand: $10.00 Non-Preferred Drug: $69.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
PHP (HMO SNP) - H3132-001-0
Benefit Details
|
Broward |
$0.00 |
$400 |
No additional gap coverage, only the Donut Hole Discount | Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 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 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
| $6,700 Browse Formulary |
|
-- |
|
|
Simply Level (HMO SNP) - H5471-054-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
Simply More (HMO) - H5471-051-0
Benefit Details
|
Broward |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 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 |
Sunshine Health Medicare Advantage (HMO) - H9276-003-0
Benefit Details
|
Broward |
$0.00 |
$100 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $38.00 Non-Preferred Brand: $85.00 Specialty Tier: 31% Select Care Drugs: $0.00
| $5,900 Browse Formulary |
new |
new |
new |
|
Symphony Plus (HMO) - H4627-007-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Brand: $97.00 Specialty Tier: 33%
| $3,400 Browse Formulary |
|
|
|
|
WellCare Dividend (HMO) - H1032-179-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $75.00 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 |
WellCare Value (HMO-POS) - H1032-133-0
Benefit Details
|
Broward |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Drug: 48% Specialty Tier: 33%
| $6,700 Browse Formulary |
|
|
|
|
WellCare Reserve (HMO) - H1032-183-0
Benefit Details
|
Broward |
$11.60 |
$400 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25%
| $6,700 Browse Formulary |
|
|
|
|
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. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: 47% Specialty Tier: 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 |
CareNeeds PLUS (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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
| n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
| n/a 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 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 47% Specialty Tier: 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 |
CareNeeds (HMO SNP) - H1019-081-0
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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
| n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
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 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 47% Specialty Tier: 25%
| n/a Browse Formulary |
|
|
|
|
UnitedHealthcare Assisted Living Plan (PPO SNP) - H0710-012-0
Benefit Details
|
Broward |
$19.20 |
$120 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
| 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 |
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 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 49% Specialty Tier: 25%
| n/a Browse Formulary |
|
|
|
|
Coventry Summit Maximum (HMO SNP) - H1609-017-0
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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
Humana Gold Plus SNP-DE H1036-255 (HMO SNP) - H1036-255-0
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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
| n/a 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 |
Capela Nursing Home Plan (HMO SNP) - H4627-009-0
Benefit Details
|
Broward |
$29.10 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| n/a 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 | Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 25%
| n/a 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
| 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 |
HealthSun MediMax (HMO) - H5431-006-0
Benefit Details
|
Broward |
$29.10 |
$400 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: 25% Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Supplemental Brand and Generic Drugs: $0.00
| $3,400 Browse Formulary |
|
-- |
|
|
Medica HealthCare Plans MedicareMax Plus (HMO 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 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
| n/a 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: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 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 |
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: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 25%
| n/a Browse Formulary |
|
|
|
|
Preferred Medicare Assist (HMO 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 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
| n/a Browse Formulary |
|
-- |
|
|
Royale Duals (HMO SNP) - H4627-008-0
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 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Brand: $100.00 Specialty Tier: 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 |
Simply Care (HMO SNP) - H5471-053-0
Benefit Details
|
Broward |
$29.10 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
Simply Comfort (HMO SNP) - H5471-055-0
Benefit Details
|
Broward |
$29.10 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
|
|
|
Simply Complete (HMO SNP) - H5471-050-0
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 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 25%
| n/a 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 |
Sunshine Health Medicare 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 | Preferred Generic: $0.00 Generic: $19.00 Preferred Brand: $47.00 Non-Preferred Brand: $100.00 Specialty Tier: 25%
| n/a Browse Formulary |
-- |
-- |
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UnitedHealthcare Dual Complete RP (Regional PPO SNP) - R7444-012-0
Benefit Details
|
Broward |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd
| n/a Browse Formulary |
|
|
|
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UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP) - R7444-013-0
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
| n/a 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 |
UnitedHealthcare Nursing Home Plan (PPO SNP) - H0710-010-0
Benefit Details
|
Broward |
$29.10 |
$400 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: tbd
| n/a Browse Formulary |
|
-- |
|
|
Waltz Community Plan (HMO SNP) - H4627-010-0
Benefit Details
|
Broward |
$29.10 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $10.00 Preferred Brand: $15.00 Non-Preferred Brand: $35.00 Specialty Tier: 33%
| n/a Browse Formulary |
|
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BlueMedicare Regional PPO (Regional PPO) - R3332-001-0
Benefit Details
|
Broward |
$41.00 |
$280 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Generic: $13.00 Preferred Brand: $40.00 Non-Preferred Brand: $93.00 Specialty Tier: 27%
| $6,700 Browse Formulary |
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|
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
|
Broward |
$56.00 |
$350 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 26%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0
Benefit Details
|
Broward |
$95.00 |
$100 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $3.00 Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Drug: $85.00 Specialty Tier: 31%
| $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Humana Gold Choice H8145-061 (PFFS) - H8145-061-0
Benefit Details
|
Broward |
$110.00 |
$200 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $7.00 Generic: $17.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 29%
| n/a 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 |
BlueMedicare PPO (PPO) - H5434-002-0
Benefit Details
|
Broward |
$147.80 |
$315 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $12.00 Generic: $13.00 Preferred Brand: $40.00 Non-Preferred Brand: $93.00 Specialty Tier: 26%
| $5,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|