AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS) - H4527-024-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
|
|
|
AARP Medicare Advantage Patriot No Rx TX-MA05 (PPO) - H1278-027-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,900 |
|
|
|
|
Aetna Medicare Eagle II (PPO) - H2293-015-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 |
|
new |
new |
|
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) - H3288-051-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,000 |
|
|
|
|
Blue Cross Medicare Advantage Protect (PPO) - H4801-019-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,350 |
|
|
|
|
Cigna Courage Medicare (HMO) - H4513-009-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,300 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Erickson Advantage Liberty no Rx (HMO-POS) - H5652-002-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $7,300 |
|
|
|
|
Humana USAA Honor (PPO) - H5216-128-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,400 |
|
|
|
|
Humana USAA Honor (PPO) - H5216-348-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,900 |
|
|
|
|
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
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,100 |
|
|
|
|
Memorial Hermann Prime Value MA Only (HMO) - H7115-006-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,950 |
|
|
|
|
Wellcare TexanPlus Patriot Giveback (HMO) - H4506-010-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 |
|
|
|
|
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-0006 (PPO) - H1278-014-0
Benefits & Contact Info
|
Harris |
$0.00 |
$245 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: 29%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
AARP Medicare Advantage from UHC TX-0009 (HMO-POS) - H4514-007-0
Benefits & Contact Info
|
Harris |
$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 | $5,900 Browse Formulary |
|
|
|
|
AARP Medicare Advantage from UHC TX-0015 (HMO-POS) - H4527-037-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,800 Browse Formulary |
|
|
|
|
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-001P (HMO-POS) - H4514-014-0
Benefits & Contact Info
|
Harris |
$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 | $3,700 Browse Formulary |
|
|
|
|
AARP Medicare Advantage from UHC TX-0031 (PPO) - H1278-021-0
Benefits & Contact Info
|
Harris |
$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 | $7,900 Browse Formulary |
|
|
|
|
Aetna Medicare Freedom Plan (PPO) - H2293-016-0
Benefits & Contact Info
|
Harris |
$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 | $5,900 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 |
Aetna Medicare Premier Plan (HMO) - H4523-015-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Prime Plan (HMO) - H4523-024-0
Benefits & Contact Info
|
Harris |
$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 | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Select Plan (HMO) - H8332-003-0
Benefits & Contact Info
|
Harris |
$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 | $3,850 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 |
Aetna Medicare Value Plan (PPO) - H3288-047-0
Benefits & Contact Info
|
Harris |
$0.00 |
$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 | $7,550 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Basic (HMO) - H8133-001-0
Benefits & Contact Info
|
Harris |
$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 | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Classic (PPO) - H4801-002-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
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 Saver (HMO) - H9706-008-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
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: 33%
all covered insulin pay $35 or less | $6,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Value (HMO) - H9706-005-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
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: 33%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna Alliance Medicare (HMO) - H4513-064-0
Benefits & Contact Info
|
Harris |
$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 | $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 |
Cigna Preferred Medicare (HMO) - H4513-061-1
Benefits & Contact Info
|
Harris |
$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 | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna Preferred Savings Medicare (HMO) - H4513-083-1
Benefits & Contact Info
|
Harris |
$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 | $6,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna True Choice Medicare (PPO) - H7849-038-0
Benefits & Contact Info
|
Harris |
$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 | $6,100 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 |
Devoted CORE Greater Houston (HMO) - H7993-001-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Devoted GIVEBACK Greater Houston (HMO) - H7993-006-0
Benefits & Contact Info
|
Harris |
$0.00 |
$395 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $6,900 Browse Formulary |
|
|
|
|
Erickson Advantage Guardian (HMO-POS I-SNP) - H5652-003-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $28.00 Non-Preferred Drug: $70.00 Specialty Tier: 33%
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 |
Erickson Advantage Liberty (HMO-POS) - H5652-008-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $7,300 Browse Formulary |
|
|
|
|
Humana Gold Plus H0028-042 (HMO) - H0028-042-0
Benefits & Contact Info
|
Harris |
$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 | $3,450 Browse Formulary |
|
|
|
|
HumanaChoice H5216-043 (PPO) - H5216-043-6
Benefits & Contact Info
|
Harris |
$0.00 |
$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 | $6,700 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-358 (PPO) - H5216-358-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
KelseyCare Advantage Classic (HMO) - H0332-002-0
Benefits & Contact Info
|
Harris |
$0.00 |
$100 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,450 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
KelseyCare Advantage Freedom (HMO-POS) - H0332-004-0
Benefits & Contact Info
|
Harris |
$0.00 |
$100 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 31% Select Care 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 |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
KelseyCare Advantage Honor (HMO) - H0332-001-0
Benefits & Contact Info
|
Harris |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,850 |
|
|
|
|
KelseyCare Advantage Secure (HMO) - H0332-010-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
KelseyCare Advantage Signature (HMO) - H0332-009-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $4,000 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 |
KelseyCare Advantage Thrive (HMO-POS) - H0332-011-0
Benefits & Contact Info
|
Harris |
$0.00 |
$100 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $90.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,000 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Memorial Hermann Advantage (HMO) - H7115-001-0
Benefits & Contact Info
|
Harris |
$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% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,950 Browse Formulary |
|
|
|
|
Molina Dual Options (Medicare-Medicaid Plan) - H8197-002-2
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
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 |
Molina Medicare Choice Care (HMO) - H7678-004-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
Molina Medicare Choice Care Select (HMO) - H7678-005-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
SCAN Balance (HMO C-SNP) - H8902-006-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a 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 |
SCAN Classic (HMO) - H8902-005-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
SCAN Heart First (HMO C-SNP) - H8902-007-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
new |
new |
Higher cost-sharing at standard network pharmacies. Details:
|
SCAN Venture (HMO) - H8902-008-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $5,000 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 |
UHC Complete Care TX-002P (HMO-POS C-SNP) - H4514-015-0
Benefits & Contact Info
|
Harris |
$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 | n/a Browse Formulary |
|
|
|
|
UnitedHealthcare Connected (Medicare-Medicaid Plan) - H7833-001-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Verda Noble Care (HMO) - H5163-001-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $1,899 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 |
Verda Noble Chronic Care (HMO C-SNP) - H5163-002-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $32.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Wellcare Mutual of Omaha No Premium Open (PPO) - H7323-003-0
Benefits & Contact Info
|
Harris |
$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: 50% Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Mutual of Omaha No Premium Secure Open (PPO) - H7323-012-0
Benefits & Contact Info
|
Harris |
$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 | $5,900 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 |
Wellcare No Premium (HMO) - H0174-010-0
Benefits & Contact Info
|
Harris |
$0.00 |
$275 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: 49% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Rx Plus Open (PPO) - H7323-006-0
Benefits & Contact Info
|
Harris |
$0.00 |
$300 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 28% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $6,000 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare TexanPlus Classic No Premium (HMO) - H4506-003-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 49% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,400 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 |
Wellcare TexanPlus No Premium (HMO-POS) - H4506-029-0
Benefits & Contact Info
|
Harris |
$0.00 |
$250 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 29% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint Chronic Care (HMO C-SNP) - H8849-003-0
Benefits & Contact Info
|
Harris |
$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:
|
Wellpoint Home Care (HMO I-SNP) - H8849-002-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
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
|
Harris |
$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) - H8849-005-0
Benefits & Contact Info
|
Harris |
$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
|
Harris |
$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 |
Wellpoint Select (HMO) - H8849-009-0
Benefits & Contact Info
|
Harris |
$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 | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellpoint STAR+PLUS MMP (Medicare-Medicaid Plan) - H8786-001-0
Benefits & Contact Info
|
Harris |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0% Tier 4: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Devoted PRIME Greater Houston (HMO) - H7993-002-0
Benefits & Contact Info
|
Harris |
$15.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $80.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana Gold Choice H8145-126 (PFFS) - H8145-126-0
Benefits & Contact Info
|
Harris |
$15.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | n/a |
|
|
|
|
UHC Complete Care TX-0029 (Regional PPO C-SNP) - R6801-009-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
Aetna Medicare Value Plus (PPO) - H3288-003-0
Benefits & Contact Info
|
Harris |
$23.00 |
$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 | $5,900 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 |
UHC Care Advantage EX-E001 (PPO I-SNP) - H0710-058-0
Benefits & Contact Info
|
Harris |
$28.40 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
|
Humana Gold Choice H8145-084 (PFFS) - H8145-084-0
Benefits & Contact Info
|
Harris |
$45.00 |
$250 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $6.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 29%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
UHC Medicare Advantage TX-0030 (Regional PPO) - R6801-012-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R4182-004 (Regional PPO) - R4182-004-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
Erickson Advantage Freedom (HMO-POS) - H5652-006-0
Benefits & Contact Info
|
Harris |
$64.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,300 Browse Formulary |
|
|
|
|
HumanaChoice H5216-042 (PPO) - H5216-042-0
Benefits & Contact Info
|
Harris |
$65.00 |
$200 Tier 1, 2 and 3 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice R4182-003 (Regional PPO) - R4182-003-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
|
Blue Cross Medicare Advantage Choice Premier (PPO) - H1666-003-0
Benefits & Contact Info
|
Harris |
$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 |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Erickson Advantage Signature (HMO-POS) - H5652-001-0
Benefits & Contact Info
|
Harris |
$168.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,600 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Erickson Advantage Champion (HMO-POS C-SNP) - H5652-004-0
Benefits & Contact Info
|
Harris |
$188.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $85.00 Specialty Tier: 33%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|