AARP Medicare Advantage Patriot No Rx VA-MA01 (PPO) - H2577-015-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,500 |
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|
Aetna Medicare Eagle (PPO) - H5521-322-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,900 |
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Anthem Veteran (PPO) - H4909-020-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
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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 |
Humana USAA Honor (PPO) - H5216-310-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $8,850 |
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Humana USAA Honor (Regional PPO) - R1390-003-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
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HumanaChoice H5216-152 (PPO) - H5216-152-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 |
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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 |
HumanaChoice R1390-001 (Regional PPO) - R1390-001-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,350 |
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AARP Medicare Advantage from UHC VA-0004 (PPO) - H2577-011-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $7,500 Browse Formulary |
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AARP Medicare Advantage from UHC VA-0008 (HMO-POS) - H5253-087-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,300 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 |
AARP Medicare Advantage from UHC VA-0013 (HMO-POS) - H5253-119-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$350 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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AARP Medicare Advantage from UHC VA-0016 (PPO) - H2406-123-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Aetna Medicare Premier Plan (PPO) - H5521-395-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 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 | $7,900 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 |
Aetna Medicare Select Plan (HMO-POS) - H3931-100-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare SmartFit (PPO) - H5521-396-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$250 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 29%
all covered insulin pay $35 or less | $3,650 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Anthem Grocery (HMO) - H3447-039-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 Tier 1, 2, 3 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $4,900 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 |
Anthem Grocery (PPO) - H4909-026-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$95 Tier 1, 2, 3 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Anthem Kidney Care (HMO C-SNP) - H3447-033-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$325 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 28% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Anthem Medicare Advantage (HMO) - H3447-013-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 Tier 1, 2, 3 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,900 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 |
Anthem Medicare Advantage (PPO) - H4909-014-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$95 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $13.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Clear Spring Health Essential (HMO C-SNP) - H8293-002-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$250 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 29%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Clear Spring Health Essential (HMO) - H8293-001-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,250 Browse Formulary |
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-- |
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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 |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) - H6622-084-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$145 Tier 1, 2, 3 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Humana Gold Plus H5619-157 (HMO) - H5619-157-0
Benefits & Contact Info
|
Poquoson City |
$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 Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,400 Browse Formulary |
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Humana Gold Plus H6622-004 (HMO) - H6622-004-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,900 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 |
Humana Gold Plus H6622-083 (HMO) - H6622-083-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,650 Browse Formulary |
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HumanaChoice H5216-266 (PPO) - H5216-266-0
Benefits & Contact Info
|
Poquoson City |
$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 Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,400 Browse Formulary |
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HumanaChoice H5216-308 (PPO) - H5216-308-0
Benefits & Contact Info
|
Poquoson City |
$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 Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $8,300 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 |
HumanaChoice H5216-312 (PPO) - H5216-312-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,900 Browse Formulary |
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Molina Medicare Choice Care (HMO) - H7559-003-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
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Sentara Medicare Engage-Diabetes and Heart (HMO C-SNP) - H2563-018-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 Tier 1, 2 and 3 exempt |
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 | 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 |
Sentara Medicare Salute (HMO) - H2563-014-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 |
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|
|
Sentara Medicare Savings (HMO) - H2563-019-0
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 Tier 1, 2 and 3 exempt |
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 | $3,400 Browse Formulary |
|
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Sentara Medicare Value (HMO) - H2563-017-2
Benefits & Contact Info
|
Poquoson City |
$0.00 |
$150 Tier 1, 2 and 3 exempt |
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 | $3,000 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 |
Sentara Community Complete Select (HMO D-SNP) - H2563-020-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Sentara Community Complete (HMO D-SNP) - H2563-004-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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|
Aetna Medicare Essential Plan (PPO) - H5521-084-0
Benefits & Contact Info
|
Poquoson City |
$18.00 |
$300 Tier 1 and 2 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 | $5,400 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 |
Humana Together in Health (PPO I-SNP) - H5216-362-0
Benefits & Contact Info
|
Poquoson City |
$18.30 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
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|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) - H5619-145-0
Benefits & Contact Info
|
Poquoson City |
$21.70 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
Anthem Extra Help (HMO) - H3447-028-0
Benefits & Contact Info
|
Poquoson City |
$25.10 |
$545 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $95.00 Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 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 |
Anthem Dual Advantage (HMO D-SNP) - H3447-030-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00 Tier 6: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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|
Molina Medicare Complete Care Select (HMO D-SNP) - H7559-002-0
Benefits & Contact Info
|
Poquoson City |
$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: 15%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
AARP Medicare Advantage from UHC VA-0009 (HMO-POS) - H5253-088-0
Benefits & Contact Info
|
Poquoson City |
$31.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,700 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 |
Aetna Medicare Assure Value (HMO D-SNP) - H1610-003-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
Molina Medicare Complete Care (HMO D-SNP) - H7559-001-0
Benefits & Contact Info
|
Poquoson City |
$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 |
|
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|
|
Aetna Better Health of Virginia (HMO D-SNP) - H1610-001-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $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 |
Aetna Medicare Assure Premier (HMO D-SNP) - H1610-002-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
Anthem Dual Advantage (PPO D-SNP) - H4909-018-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00 Tier 6: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Anthem Full Dual Advantage (HMO D-SNP) - H3447-045-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00 Tier 6: $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 |
Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00 Tier 6: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
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|
|
Anthem Full Dual Advantage Support (HMO D-SNP) - H3447-044-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00 Tier 6: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Plus H6622-085 (HMO) - H6622-085-0
Benefits & Contact Info
|
Poquoson City |
$38.50 |
$545 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: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $6,400 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 |
HumanaChoice H5216-363 (PPO) - H5216-363-0
Benefits & Contact Info
|
Poquoson City |
$38.50 |
$545 Tier 1 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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UHC Dual Complete VA-Q001 (HMO-POS D-SNP) - H7464-006-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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UHC Dual Complete VA-S001 (PPO D-SNP) - H1889-006-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | 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 |
UHC Dual Complete VA-S002 (HMO-POS D-SNP) - H7464-001-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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UHC Dual Complete VA-V001 (HMO-POS D-SNP) - H7464-013-0
Benefits & Contact Info
|
Poquoson City |
$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: 15% Tier 2: 15% Tier 3: 15% Tier 4: 15% Tier 5: 15%
all covered insulin pay $35 or less | n/a Browse Formulary |
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UHC Dual Complete VA-Y001 (HMO-POS D-SNP) - H7464-005-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | 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 |
UHC Dual Complete VA-Y002 (HMO-POS D-SNP) - H7464-007-0
Benefits & Contact Info
|
Poquoson City |
$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 Tier 2: $0.00 Tier 3: $0.00 Tier 4: $0.00 Tier 5: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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HumanaChoice H5216-144 (PPO) - H5216-144-0
Benefits & Contact Info
|
Poquoson City |
$39.00 |
$265 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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Sentara Medicare Prime (HMO) - H2563-005-2
Benefits & Contact Info
|
Poquoson City |
$53.00 |
$130 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Drug: $90.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $5,500 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 R1390-002 (Regional PPO) - R1390-002-0
Benefits & Contact Info
|
Poquoson City |
$105.00 |
$480 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $8.00 Generic: $18.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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