AARP Medicare Advantage Patriot No Rx TX-MA02 (HMO-POS) - H0609-055-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,400 |
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AARP Medicare Advantage Patriot No Rx TX-MA06 (PPO) - H1278-025-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,900 |
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Blue Cross Medicare Advantage Protect (PPO) - H4801-019-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,350 |
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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 |
Care N' Care Choice MA-Only (PPO) - H6328-005-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,500 |
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Humana USAA Honor (PPO) - H5216-128-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,400 |
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Humana USAA Honor (PPO) - H5216-348-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,900 |
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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 R4182-001 (Regional PPO) - R4182-001-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,100 |
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Wellcare Patriot No Premium (HMO) - H5294-014-0
Benefits & Contact Info
|
Wise |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,450 |
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|
AARP Medicare Advantage from UHC TX-0005 (PPO) - H1278-013-0
Benefits & Contact Info
|
Wise |
$0.00 |
$260 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: 29%
all covered insulin pay $35 or less | $6,300 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 TX-0027 (HMO-POS) - H0609-061-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,800 Browse Formulary |
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AARP Medicare Advantage from UHC TX-0039 (HMO-POS) - H0609-066-0
Benefits & Contact Info
|
Wise |
$0.00 |
$295 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $6,500 Browse Formulary |
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AARP SecureHorizons Medicare Advantage TX-0022 (HMO-POS) - H0609-051-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,800 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 Choice Plan (PPO) - H3288-008-0
Benefits & Contact Info
|
Wise |
$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 | $6,350 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Freedom Plan (PPO) - H2293-013-0
Benefits & Contact Info
|
Wise |
$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 | $6,350 Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Choice Plus (PPO) - H1666-006-0
Benefits & Contact Info
|
Wise |
$0.00 |
$545 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $7,950 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 |
Blue Cross Medicare Advantage Classic (PPO) - H4801-002-0
Benefits & Contact Info
|
Wise |
$0.00 |
$200 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $5,900 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Dental Premier (PPO) - H4801-016-0
Benefits & Contact Info
|
Wise |
$0.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Health Choice (PPO) - H4801-018-0
Benefits & Contact Info
|
Wise |
$0.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $6,900 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 |
Care N' Care Choice (PPO) - H6328-003-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $12.00 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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Care N' Care Classic (HMO) - H2171-001-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
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Cigna Preferred Medicare (HMO) - H4513-061-5
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,100 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 |
Cigna Preferred Savings Medicare (HMO) - H4513-083-5
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Cigna True Choice Medicare (PPO) - H7849-134-1
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $6,400 Browse Formulary |
|
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) - H0028-060-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
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 |
Humana Gold Plus H0028-043 (HMO) - H0028-043-1
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
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HumanaChoice H5216-352 (PPO) - H5216-352-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,800 Browse Formulary |
|
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HumanaChoice H5216-358 (PPO) - H5216-358-0
Benefits & Contact Info
|
Wise |
$0.00 |
$395 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: 27%
all covered insulin pay $35 or less | $7,500 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 |
Molina Medicare Choice Care (HMO) - H7678-004-0
Benefits & Contact Info
|
Wise |
$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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Molina Medicare Choice Care Select (HMO) - H7678-005-0
Benefits & Contact Info
|
Wise |
$0.00 |
$200 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
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Wellcare Mutual of Omaha No Premium Open (PPO) - H7323-002-0
Benefits & Contact Info
|
Wise |
$0.00 |
$200 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 46% Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,900 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 |
Wellcare Mutual of Omaha No Premium Secure Open (PPO) - H7323-011-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 48% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium (HMO) - H0174-014-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 49% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint Chronic Care (HMO C-SNP) - H8849-001-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.50 Preferred Brand: $35.00 Non-Preferred Drug: $85.00 Specialty Tier: 33% Select Care Drugs: $0.00
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 |
Wellpoint Kidney Care (HMO C-SNP) - H2593-043-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $12.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint Lung Care (HMO C-SNP) - H8849-013-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.50 Preferred Brand: $40.00 Non-Preferred Drug: $85.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint Medicare Advantage 2 (HMO) - H2593-029-0
Benefits & Contact Info
|
Wise |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $3.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $8,300 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 |
UHC Complete Care TX-001A (Regional PPO C-SNP) - R6801-008-0
Benefits & Contact Info
|
Wise |
$10.00 |
$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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|
|
Cigna TotalCare (HMO D-SNP) - H4513-060-5
Benefits & Contact Info
|
Wise |
$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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|
|
Humana Together in Health (PPO I-SNP) - H5216-369-0
Benefits & Contact Info
|
Wise |
$15.30 |
$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 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-043 (PPO) - H5216-043-1
Benefits & Contact Info
|
Wise |
$16.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $7,200 Browse Formulary |
|
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|
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Wellcare Complement Assist (HMO) - H5294-016-0
Benefits & Contact Info
|
Wise |
$21.10 |
$505 Tier 1 and 6 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% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint Dual Advantage 2 (HMO D-SNP) - H2593-032-0
Benefits & Contact Info
|
Wise |
$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% Tier 6: 15%
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 |
Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP) - H9706-002-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
Wellcare Dual Access Harmony (HMO D-SNP) - H5294-015-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
UHC Complete Care TX-0029 (Regional PPO C-SNP) - R6801-009-0
Benefits & Contact Info
|
Wise |
$22.00 |
$295 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
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 |
UHC Dual Complete TX-V010 (HMO-POS D-SNP) - H5322-038-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
Wellcare Dual Liberty Nurture (HMO D-SNP) - H5294-010-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
AARP Medicare Advantage from UHC TX-0042 (HMO-POS) - H0609-070-0
Benefits & Contact Info
|
Wise |
$24.00 |
$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 | $3,300 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 Dual Complete Plan (HMO D-SNP) - H8597-002-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
Humana Gold Plus H0028-059 (HMO) - H0028-059-0
Benefits & Contact Info
|
Wise |
$26.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
|
Humana Gold Plus SNP-DE H0028-031 (HMO D-SNP) - H0028-031-0
Benefits & Contact Info
|
Wise |
$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 |
Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP) - H0028-032-0
Benefits & Contact Info
|
Wise |
$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 |
|
|
|
|
Molina Medicare Complete Care (HMO D-SNP) - H7678-001-0
Benefits & Contact Info
|
Wise |
$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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Provider Partners Texas Advantage Plan (HMO I-SNP) - H4054-001-0
Benefits & Contact Info
|
Wise |
$28.40 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
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new |
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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 TX-D007 (HMO-POS D-SNP) - H5322-025-0
Benefits & Contact Info
|
Wise |
$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 TX-S001 (Regional PPO D-SNP) - R6801-011-0
Benefits & Contact Info
|
Wise |
$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 TX-S003 (HMO-POS D-SNP) - H4514-021-0
Benefits & Contact Info
|
Wise |
$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 |
Wellcare Dual Access Open (PPO D-SNP) - H7323-005-0
Benefits & Contact Info
|
Wise |
$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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|
Wellpoint Dual Advantage (HMO D-SNP) - H8849-011-2
Benefits & Contact Info
|
Wise |
$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% Tier 6: 15%
all covered insulin pay $35 or less | n/a Browse Formulary |
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Wellpoint Full Dual Advantage (HMO D-SNP) - H8849-010-2
Benefits & Contact Info
|
Wise |
$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 |
Wellpoint Full Dual Advantage 2 (HMO D-SNP) - H2593-054-0
Benefits & Contact Info
|
Wise |
$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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UHC Medicare Advantage TX-0030 (Regional PPO) - R6801-012-0
Benefits & Contact Info
|
Wise |
$48.00 |
$395 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
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HumanaChoice R4182-004 (Regional PPO) - R4182-004-0
Benefits & Contact Info
|
Wise |
$49.00 |
$275 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $6.00 Generic: $13.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $6,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Care N' Care Choice Plus (PPO) - H6328-002-0
Benefits & Contact Info
|
Wise |
$50.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $45.00 Non-Preferred Drug: $97.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
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AARP SecureHorizons Medicare Advantage TX-0025 (HMO-POS) - H0609-059-0
Benefits & Contact Info
|
Wise |
$68.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
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HumanaChoice R4182-003 (Regional PPO) - R4182-003-0
Benefits & Contact Info
|
Wise |
$72.00 |
$175 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Blue Cross Medicare Advantage Choice Premier (PPO) - H1666-003-0
Benefits & Contact Info
|
Wise |
$88.00 |
$295 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28%
all covered insulin pay $35 or less | $6,355 Browse Formulary |
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|
Higher cost-sharing at standard network pharmacies. Details:
|
Care N' Care Choice Premium (PPO) - H6328-001-0
Benefits & Contact Info
|
Wise |
$195.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $43.00 Non-Preferred Drug: $92.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,500 Browse Formulary |
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Blue Cross Medicare Advantage Flex (PPO) - H4801-014-0
Benefits & Contact Info
|
Wise |
$238.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|