AARP Medicare Advantage Patriot No Rx FL-MA01 (Regional PPO) - R0759-002-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,900 |
|
|
|
|
AARP Medicare Advantage Patriot No Rx FL-MA2 (PPO) - H2406-130-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,900 |
|
|
|
|
Aetna Medicare Eagle (PPO) - H5521-347-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
BlueMedicare Patriot (PPO) - H5434-041-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
|
|
|
Humana USAA Honor Giveback (HMO) - H1036-290-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 |
|
|
|
|
Humana USAA Honor Giveback (PPO) - H5216-257-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,000 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,550 |
|
-- |
|
|
Wellcare Patriot Giveback (HMO) - H1032-238-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,000 |
|
-- |
|
|
AARP Medicare Advantage CareFlex from UHC FL-37 (HMO-POS) - H1045-067-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$495 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $6.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
AARP Medicare Advantage from UHC FL-0005 (HMO-POS) - H1045-026-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$175 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
|
|
|
AARP Medicare Advantage from UHC FL-0021 (PPO) - H2406-013-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$420 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | 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 | $5,900 Browse Formulary |
|
|
|
|
Aetna Medicare Choice (HMO-POS) - H1609-028-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 24% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $5,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare FL Explorer Premier (PPO) - H5521-434-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 24% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,150 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare FL Select (HMO) - H1609-021-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 35% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,300 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Premier (PPO) - H5521-033-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 24% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,750 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Premier (PPO) - H5521-269-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 24% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
BlueMedicare Classic (HMO) - H1035-019-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,500 Browse Formulary |
|
|
|
|
BlueMedicare Value (PPO) - H5434-031-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$175 Tier 1, 2 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,100 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
CareAccess (HMO) - H1019-144-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Drug: 35% Specialty Tier: 33%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
CareBreeze Platinum (HMO C-SNP) - H1019-118-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,800 Browse Formulary |
|
|
|
|
CareComplete (HMO C-SNP) - H1019-150-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
CareComplete Platinum (HMO C-SNP) - H1019-109-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
|
CareFree Platinum Giveback (HMO) - H1019-094-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Drug: 35% Specialty Tier: 31%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
|
CareNeeds Platinum (HMO D-SNP) - H1019-146-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
CareNeeds Plus (HMO D-SNP) - H1019-073-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: 24% Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
CareOne Plus (HMO) - H1019-113-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,500 Browse Formulary |
|
|
|
|
Devoted CORE Florida (HMO) - H1290-029-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Devoted DUAL PLUS Florida (HMO D-SNP) - H1290-052-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: 25% Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Devoted EXTRA Florida (HMO) - H1290-059-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
Devoted GIVEBACK Florida (HMO) - H1290-031-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,750 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
FHCP Medicare Premier Advantage (HMO) - H1035-040-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$295 Tier 1, 2, 3 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $44.00 Non-Preferred Drug: 25% Specialty Tier: 29% Vaccines: $0.00
all covered insulin pay $35 or less | $5,100 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
FHCP Medicare Rx Savings (HMO) - H1035-014-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$590 Tier 1, 2 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Drug: 25% Specialty Tier: 25% Vaccines: $0.00
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Humana Full Access Giveback H5216-393 (PPO) - H5216-393-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Drug: 33% Specialty Tier: 28%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Plus - Diabetes and Heart (HMO C-SNP) - H1036-302-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,300 Browse Formulary |
|
|
|
|
Humana Gold Plus Giveback H1036-270 (HMO) - H1036-270-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $41.00 Non-Preferred Drug: 49% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
|
Humana Gold Plus H1036-068 (HMO) - H1036-068-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Drug: 35% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,300 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Plus Lung (HMO C-SNP) - H1036-316-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,300 Browse Formulary |
|
|
|
|
Humana Gold Plus SNP-DE H1036-210 (HMO D-SNP) - H1036-210-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Humana Gold Plus SNP-DE H1036-314 (HMO D-SNP) - H1036-314-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice Florida H5216-070 (PPO) - H5216-070-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$275 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $2.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: 41% Specialty Tier: 29%
all covered insulin pay $35 or less | $6,750 Browse Formulary |
|
|
|
|
HumanaChoice Florida H7284-009 (PPO) - H7284-009-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$350 Tier 1, 2 and 3 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: 40% Specialty Tier: 28%
all covered insulin pay $35 or less | $5,500 Browse Formulary |
|
|
|
|
Simply Complete (HMO D-SNP) - H5471-111-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: $1.00 Generic: $3.00 Preferred Brand: 14% Non-Preferred Drug: 25% Specialty Tier: 25% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $500 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Simply Extra (HMO) - H5471-112-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Simply Freedom (PPO) - H9469-003-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$150 Tier 1, 2 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 25% Specialty Tier: 31% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $6,800 Browse Formulary |
|
new |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Simply More (HMO) - H5471-110-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $85.00 Specialty Tier: 33% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Giveback (HMO) - H1032-204-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$420 Tier 1, 2 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 39% Specialty Tier: 28% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
|
-- |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Simple (HMO) - H1032-205-0
Benefits & Contact Info
|
St. Johns |
$0.00 |
$420 Tier 1, 2 and 6 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 25% Non-Preferred Drug: 45% Specialty Tier: 28% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
-- |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Devoted DUAL Florida (HMO D-SNP) - H1290-023-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Enhanced Alternative (EA) | Preferred Generic: 25% Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare FL Dual Select (HMO D-SNP) - H1609-045-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $4,150 Browse Formulary |
|
|
|
|
UHC Dual Complete FL-D002 (HMO-POS D-SNP) - H1045-039-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
|
|
|
Wellcare Dual Access (HMO D-SNP) - H1032-124-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Dual Liberty (HMO D-SNP) - H1032-175-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
-- |
|
|
HumanaChoice Florida SNP-DE H5216-394 (PPO D-SNP) - H5216-394-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
|
UHC Dual Complete FL-D003 (PPO D-SNP) - H1889-002-1
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UHC Dual Complete FL-D005 (Regional PPO D-SNP) - R0759-003-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
|
|
|
UHC Dual Complete FL-Y001 (HMO-POS D-SNP) - H2509-001-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
new |
|
|
UHC Dual Complete FL-Y4 (PPO D-SNP) - H1889-026-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UHC Dual Complete FL-Y5 (HMO-POS D-SNP) - H2509-003-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $9,350 Browse Formulary |
|
new |
|
|
Wellcare Dual Reserve (HMO D-SNP) - H1032-202-0
Benefits & Contact Info
|
St. Johns |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Defined Standard (DS) | All formulary drugs: 25%
all covered insulin pay $35 or less | $1,500 Browse Formulary |
|
-- |
|
|
AARP Medicare Advantage from UHC FL-0031 (Regional PPO) - R0759-001-0
Benefits & Contact Info
|
St. Johns |
$23.00 |
$570 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 26%
all covered insulin pay $35 or less | $7,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible | Drug Benefit Detail | Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R5826-074 (Regional PPO) - R5826-074-0
Benefits & Contact Info
|
St. Johns |
$23.00 |
$395 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $6.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 48% Specialty Tier: 28%
all covered insulin pay $35 or less | $7,550 Browse Formulary |
|
-- |
|
|
FHCP Medicare Rx Plus (HMO-POS) - H1035-002-0
Benefits & Contact Info
|
St. Johns |
$49.00 |
$0 |
Enhanced Alternative (EA) | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 25% Specialty Tier: 33% Vaccines: $0.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0
Benefits & Contact Info
|
St. Johns |
$172.00 |
$100 Tier 1 and 2 exempt |
Enhanced Alternative (EA) | Preferred Generic: $5.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 31%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|