Lasso Healthcare Growth (MSA) - H1924-001-0
Benefit Details
|
Worcester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
Lasso Healthcare Growth Plus (MSA) - H1924-004-0
Benefit Details
|
Worcester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UnitedHealthcare Connected(r) for One Care (Medicare-Medicaid Plan) - H9239-001-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
AARP Medicare Advantage Choice (PPO) - H3442-004-0
Benefit Details
|
Worcester |
$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%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
AARP Medicare Advantage Patriot (PPO) - H3442-005-0
Benefit Details
|
Worcester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
|
|
|
|
AARP Medicare Advantage Plan 1 (HMO-POS) - H1944-005-0
Benefit Details
|
Worcester |
$0.00 |
$195 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $5,700 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 Eagle Plan (PPO) - H5521-296-0
Benefit Details
|
Worcester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
|
|
|
|
Aetna Medicare Explorer Plan (PPO) - H5521-160-0
Benefit Details
|
Worcester |
$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%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Value Plan (HMO-POS) - H5793-014-0
Benefit Details
|
Worcester |
$0.00 |
$195 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $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 |
Align Connect (HMO C-SNP) - H1277-002-0
Benefit Details
|
Worcester |
$0.00 |
$505 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
-- |
|
Align Thrive (HMO I-SNP) - H1277-001-0
Benefit Details
|
Worcester |
$0.00 |
$505 Tier 1 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
-- |
|
CCA Medicare Preferred (PPO) - H9414-001-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
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: 29%
all covered insulin pay $35 or less | $6,500 Browse Formulary |
|
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
CCA One Care (Medicare-Medicaid Plan) - H0137-001-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
eternalHealth Forever HMO (HMO) - H1280-001-0
Benefit Details
|
Worcester |
$0.00 |
$185 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,000 Browse Formulary |
|
new |
new |
|
eternalHealth Freedom PPO (PPO) - H2694-001-0
Benefit Details
|
Worcester |
$0.00 |
$185 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
eternalHealth Give Back PPO (PPO) - H2694-002-0
Benefit Details
|
Worcester |
$0.00 |
$300 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $7,450 Browse Formulary |
|
new |
new |
|
Fallon Medicare Plus Orange HMO (HMO) - H9001-038-0
Benefit Details
|
Worcester |
$0.00 |
$200 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $37.00 Non-Preferred Brand: $86.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
|
|
|
Humana Honor (PPO) - H5216-059-0
Benefit Details
|
Worcester |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-138 (PPO) - H5216-138-0
Benefit Details
|
Worcester |
$0.00 |
$275 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $4,800 Browse Formulary |
|
|
|
|
HumanaChoice H5216-249 (PPO) - H5216-249-0
Benefit Details
|
Worcester |
$0.00 |
$295 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $5,600 Browse Formulary |
|
|
|
|
Mass Advantage Basic (HMO) - H7670-001-0
Benefit Details
|
Worcester |
$0.00 |
$195 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,500 Browse Formulary |
|
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Mass Advantage Premiere (PPO) - H9904-001-0
Benefit Details
|
Worcester |
$0.00 |
$250 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $2.00 Generic: $6.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $6,550 Browse Formulary |
|
new |
new |
|
Mass General Brigham Advantage (PPO) - H9485-001-0
Benefit Details
|
Worcester |
$0.00 |
$275 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $37.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $8,300 Browse Formulary |
new |
new |
new |
|
Medicare HMO Blue SaverRx (HMO) - H2261-024-0
Benefit Details
|
Worcester |
$0.00 |
$300 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $5,600 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 |
Medicare PPO Blue SaverRx (PPO) - H2230-017-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $5,600 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Tufts Health Unify (Medicare-Medicaid Plan) - H7419-001-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Tufts Medicare Preferred Access (PPO) - H9907-001-0
Benefit Details
|
Worcester |
$0.00 |
$150 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30% Vaccines: $0.00
all covered insulin pay $35 or less | $6,700 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 |
Service |
Exper. |
Cost Info |
Tufts Medicare Preferred HMO Saver Rx (HMO) - H2256-028-0
Benefit Details
|
Worcester |
$0.00 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Vaccines: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Tufts Medicare Preferred HMO Smart Saver Rx (HMO) - H2256-046-0
Benefit Details
|
Worcester |
$0.00 |
$100 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Vaccines: $0.00
all covered insulin pay $35 or less | $5,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Open (PPO) - H9761-002-0
Benefit Details
|
Worcester |
$0.00 |
$350 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $37.00 Non-Preferred Drug: 48% Specialty Tier: 27% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
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 |
Service |
Exper. |
Cost Info |
Wellcare No Premium (HMO) - H6193-001-0
Benefit Details
|
Worcester |
$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: 45% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) - H9761-001-0
Benefit Details
|
Worcester |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $37.00 Non-Preferred Drug: 43% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,500 Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
UnitedHealthcare Senior Care Options NHC (HMO D-SNP) - H2226-003-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | 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 |
HumanaChoice H5216-250 (PPO) - H5216-250-0
Benefit Details
|
Worcester |
$19.00 |
$250 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $5,400 Browse Formulary |
|
|
|
|
CCA Medicare Value (PPO) - H9414-002-0
Benefit Details
|
Worcester |
$20.00 |
$200 |
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%
all covered insulin pay $35 or less | $5,000 Browse Formulary |
|
new |
new |
|
Tufts Medicare Preferred HMO Basic No Rx (HMO) - H2256-041-0
Benefit Details
|
Worcester |
$20.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,650 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UnitedHealthcare Senior Care Options (HMO D-SNP) - H2226-001-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Fallon Medicare Plus Central Green HMO (HMO) - H9001-036-0
Benefit Details
|
Worcester |
$33.00 |
$250 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $37.00 Non-Preferred Brand: $86.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,200 Browse Formulary |
|
|
|
|
eternalHealth ForeverMore HMO (HMO) - H1280-002-0
Benefit Details
|
Worcester |
$35.00 |
$170 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
|
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Fallon Medicare Plus Saver No Rx HMO (HMO) - H9001-039-0
Benefit Details
|
Worcester |
$35.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
|
|
|
Longevity Health Plan (HMO I-SNP) - H9940-001-0
Benefit Details
|
Worcester |
$36.20 |
$505 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Align Premier (HMO I-SNP) - H1277-003-0
Benefit Details
|
Worcester |
$36.30 |
$505 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
all covered insulin pay $35 or less | 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 |
CCA Senior Care Options (HMO D-SNP) - H2225-001-0
Benefit Details
|
Worcester |
$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: 25% Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
NaviCare (HMO D-SNP) - H8928-001-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | n/a Browse Formulary |
|
new |
new |
|
Senior Whole Health (HMO D-SNP) - H2224-001-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | 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 |
Senior Whole Health NHC (HMO D-SNP) - H2224-003-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Tufts Health Plan Senior Care Options (HMO D-SNP) - H8330-001-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | n/a Browse Formulary |
|
new |
new |
|
Tufts Health Plan Senior Care Options CW (HMO D-SNP) - H8330-002-0
Benefit Details
|
Worcester |
$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
all covered insulin pay $35 or less | n/a Browse Formulary |
|
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
AARP Medicare Advantage Plan 2 (HMO-POS) - H1944-006-0
Benefit Details
|
Worcester |
$47.00 |
$175 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
CCA Medicare Premier (PPO) - H9414-003-0
Benefit Details
|
Worcester |
$50.00 |
$0 |
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%
all covered insulin pay $35 or less | $4,000 Browse Formulary |
|
new |
new |
|
Tufts Medicare Preferred HMO Basic Rx (HMO) - H2256-036-0
Benefit Details
|
Worcester |
$51.00 |
$225 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Vaccines: $0.00
all covered insulin pay $35 or less | $3,650 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 |
Fallon Medicare Plus Super Saver HMO (HMO) - H9001-040-0
Benefit Details
|
Worcester |
$52.00 |
$505 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $9.00 Preferred Brand: $42.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
|
|
|
Mass General Brigham Advantage Secure (HMO-POS) - H6847-001-0
Benefit Details
|
Worcester |
$52.00 |
$200 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $37.00 Non-Preferred Drug: $100.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
new |
new |
new |
|
AARP Medicare Advantage Choice (Regional PPO) - R7444-001-0
Benefit Details
|
Worcester |
$53.00 |
$295 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Medicare HMO Blue ValueRx (HMO) - H2261-022-2
Benefit Details
|
Worcester |
$55.00 |
$320 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Premium Enhanced Open (PPO) - H9761-004-0
Benefit Details
|
Worcester |
$60.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: $35.00 Non-Preferred Drug: 43% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $4,700 Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
Medicare PPO Blue ValueRx (PPO) - H2230-018-2
Benefit Details
|
Worcester |
$85.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $6.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $4,900 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 |
Mass Advantage Plus (HMO) - H7670-002-0
Benefit Details
|
Worcester |
$100.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
new |
new |
|
Medicare HMO Blue FlexRx (HMO-POS) - H2261-023-2
Benefit Details
|
Worcester |
$105.00 |
$260 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Tufts Medicare Preferred HMO Value No Rx (HMO) - H2256-040-0
Benefit Details
|
Worcester |
$112.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,650 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Fallon Medicare Plus Green HMO (HMO) - H9001-030-15
Benefit Details
|
Worcester |
$119.00 |
$250 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $37.00 Non-Preferred Brand: $86.00 Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,200 Browse Formulary |
|
|
|
|
Fallon Medicare Plus Central Blue HMO (HMO) - H9001-035-0
Benefit Details
|
Worcester |
$128.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $37.00 Non-Preferred Brand: $86.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Mass General Brigham Advantage Premier (PPO) - H9485-002-0
Benefit Details
|
Worcester |
$140.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $37.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
new |
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Tufts Medicare Preferred HMO Prime No Rx (HMO) - H2256-039-0
Benefit Details
|
Worcester |
$152.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,650 |
|
|
|
|
Tufts Medicare Preferred HMO Value Rx (HMO) - H2256-034-0
Benefit Details
|
Worcester |
$174.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Vaccines: $0.00
all covered insulin pay $35 or less | $3,650 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Tufts Medicare Preferred HMO Prime Rx (HMO) - H2256-033-0
Benefit Details
|
Worcester |
$204.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Vaccines: $0.00
all covered insulin pay $35 or less | $3,650 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Fallon Medicare Plus Blue HMO (HMO) - H9001-031-15
Benefit Details
|
Worcester |
$238.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $37.00 Non-Preferred Brand: $86.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Medicare PPO Blue PlusRx (PPO) - H2230-002-0
Benefit Details
|
Worcester |
$254.00 |
$200 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Medicare HMO Blue PlusRx (HMO) - H2261-005-0
Benefit Details
|
Worcester |
$258.00 |
$200 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|