AARP Medicare Advantage Patriot No Rx CA-MA01 (HMO-POS) - H0543-121-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,900 |
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Aetna Medicare Eagle Plan (HMO) - H4982-013-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,200 |
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Aetna Medicare Eagle Plus Plan (PPO) - H5521-369-0
Benefits & Contact Info
|
San Diego |
$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 |
Brand New Day Valor Care Plan (HMO) - H0838-048-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,850 |
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Humana USAA Honor (HMO) - H5619-121-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,999 |
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Humana USAA Honor (PPO) - H5525-078-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,900 |
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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 |
Imperial Courage Plan (HMO) - H5496-016-0
Benefits & Contact Info
|
San Diego |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,999 |
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AARP Medicare Advantage from UHC CA-0012 (HMO-POS) - H0543-152-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
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AARP Medicare Advantage from UHC CA-026P (HMO-POS) - H0543-225-0
Benefits & Contact Info
|
San Diego |
$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 | $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 |
Aetna Medicare Classic Prime Plan (HMO) - H0523-075-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $37.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $799 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Core Plan (PPO) - H5521-422-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Plus Plan (HMO) - H4982-004-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $37.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,000 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) - H0523-052-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,400 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Alignment Health AVA (PPO) - H4961-007-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $3,900 Browse Formulary |
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Alignment Health AVA + Instacart (HMO-POS) - H3815-026-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 33% Select Care Drugs: $3.00
all covered insulin pay $35 or less | $1,999 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 |
Alignment Health CalPlus + Veterans (HMO) - H3815-036-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$545 Tier 1 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $5,900 Browse Formulary |
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Alignment Health Heart & Diabetes (HMO C-SNP) - H3815-010-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Drug: $75.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Alignment Health My Choice CalPlus (HMO) - H3815-007-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $40.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $3,000 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 |
Alignment Health Platinum + Instacart (HMO-POS) - H3815-016-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $30.00 Non-Preferred Drug: $75.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $998 Browse Formulary |
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Alignment Health Select (HMO) - H3815-037-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $40.00 Non-Preferred Drug: $93.00 Specialty Tier: 33% Select Care Drugs: $3.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
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Alignment Health smartHMO (HMO) - H3815-013-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $2,499 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 |
Alignment Health the ONE + Rite Aid (HMO) - H3815-034-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $1.00 Preferred Brand: $40.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
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Anthem Medicare Advantage (HMO) - H0544-065-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 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 |
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Higher cost-sharing at standard network pharmacies. Details:
|
Anthem Prime (HMO) - H4161-003-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,000 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 |
Anthem Select (HMO) - H0544-091-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,500 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Astiva Health C-SNP Deluxe (HMO C-SNP) - H1993-007-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $28.00 Non-Preferred Drug: $75.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Astiva Health Premier Plan (HMO) - H1993-010-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $1,900 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 |
Astiva Health Savings Plan (HMO) - H1993-001-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Drug: $98.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,500 Browse Formulary |
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Blue Shield 65 Plus (HMO) - H0504-028-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,800 Browse Formulary |
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Higher cost-sharing at standard network pharmacies. Details:
|
Blue Shield AdvantageOptimum Plan 1 (HMO) - H5928-010-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,200 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 |
Brand New Day Classic Care I Plan (HMO) - H0838-050-1
Benefits & Contact Info
|
San Diego |
$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 | $1,199 Browse Formulary |
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Brand New Day Embrace Care Plan (HMO C-SNP) - H0838-039-1
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $9.00 Preferred Brand: $47.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Brand New Day Part B Savings Plan (HMO) - H0838-049-0
Benefits & Contact Info
|
San Diego |
$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% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,200 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 |
Champion Advantage (HMO C-SNP) - H6170-001-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Brand: $100.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Clever Care Active (HMO) - H7607-007-3
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Brand: $99.00 Specialty Tier: 33% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
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Clever Care Longevity (HMO) - H7607-002-3
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $99.00 Specialty Tier: 33% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $1,700 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 |
Clever Care Value (HMO) - H7607-008-3
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Brand: $99.00 Specialty Tier: 33% Supplemental Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
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Community y Mas (HMO C-SNP) - H6248-001-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $9.00 Preferred Brand: $47.00 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 |
|
Humana Gold Plus H5619-016 (HMO) - H5619-016-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 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 H5619-150 (HMO) - H5619-150-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$200 Tier 1, 2 and 3 exempt |
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: 30%
all covered insulin pay $35 or less | $5,000 Browse Formulary |
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Humana USAA Honor with Rx (PPO) - H5525-057-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$350 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27%
all covered insulin pay $35 or less | $6,100 Browse Formulary |
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HumanaChoice H5525-077 (PPO) - H5525-077-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,900 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 |
Imperial Dynamic Plan (HMO) - H5496-012-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $30.00 Non-Preferred Drug: $75.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $298 Browse Formulary |
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Imperial Senior Value (HMO C-SNP) - H5496-005-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $90.00 Specialty Tier: 33% Select Care Drugs: $3.00
all covered insulin pay $35 or less | n/a Browse Formulary |
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Imperial Strong (HMO) - H5496-014-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$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 | $8,850 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 |
Imperial Traditional (HMO) - H5496-007-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Drug: $90.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $1,349 Browse Formulary |
|
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|
|
Kaiser Permanente Senior Advantage San Diego (HMO) - H0524-037-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Vaccines ($0 cost sharing): $0.00
all covered insulin pay $35 or less | $1,999 Browse Formulary |
|
|
|
|
Kaiser Permanente Senior Advantage San Diego Value (HMO) - H0524-082-0
Benefits & Contact Info
|
San Diego |
$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% Vaccines ($0 cost sharing): $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Molina Medicare Choice Care (HMO) - H5810-014-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
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: 33% 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) - H5810-015-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$450 |
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: 25% Select Care Drugs: $5.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
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|
|
SCAN Affirm partnered with Included LGBTQ+ Health (HMO) - H5425-096-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 25% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $750 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 |
SCAN Alta (HMO) - H5425-082-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $750 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
SCAN Balance (HMO C-SNP) - H5425-105-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $30.00 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:
|
SCAN MyChoice (HMO) - H5425-109-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Drug: $70.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $750 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Scripps Classic offered by SCAN Health Plan (HMO) - H5425-005-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $3,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Sharp Direct Advantage Gold Card (HMO) - H5386-003-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
|
Sharp Direct Advantage VIP Plan (HMO) - H5386-005-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UC San Diego Health Humana (HMO) - H5619-131-0
Benefits & Contact Info
|
San Diego |
$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 | $2,200 Browse Formulary |
|
|
|
|
UHC Complete Care CA-015P (HMO-POS C-SNP) - H0543-214-0
Benefits & Contact Info
|
San Diego |
$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 |
|
|
|
|
UHC Sharp Medicare Advantage CA-001P (HMO-POS) - H0543-145-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 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 |
UHC Sharp Medicare Advantage Walgreens CA-012P (HMO-POS) - H0543-204-0
Benefits & Contact Info
|
San Diego |
$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 | $2,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Focus (HMO) - H0562-012-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$150 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 41% Specialty Tier: 30% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Specialty No Premium (HMO C-SNP) - H0562-092-0
Benefits & Contact Info
|
San Diego |
$0.00 |
$150 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $42.00 Non-Preferred Drug: 37% Specialty Tier: 30% 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 |
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP) - H3815-039-0
Benefits & Contact Info
|
San Diego |
$8.50 |
$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% Tier 6: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Aetna Medicare Value Plus Plan (HMO-POS) - H0523-080-0
Benefits & Contact Info
|
San Diego |
$13.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $37.00 Non-Preferred Drug: $99.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,000 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Molina Medicare Complete Care (HMO D-SNP) - H3038-001-0
Benefits & Contact Info
|
San Diego |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
SCAN Connections at Home (HMO D-SNP) - H0976-002-0
Benefits & Contact Info
|
San Diego |
$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 |
new |
new |
new |
|
Wellcare Dual Liberty (HMO D-SNP) - H3561-009-0
Benefits & Contact Info
|
San Diego |
$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 |
|
|
|
|
Aetna Medicare Preferred Plan (HMO D-SNP) - H4982-016-0
Benefits & Contact Info
|
San Diego |
$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 |
SCAN Connections (HMO D-SNP) - H0976-001-0
Benefits & Contact Info
|
San Diego |
$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 |
new |
new |
new |
|
UHC Complete Care CA-06AP (HMO C-SNP) - H0543-246-0
Benefits & Contact Info
|
San Diego |
$24.10 |
$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 |
|
|
|
|
Molina Medicare Complete Care Plus (HMO D-SNP) - H3038-003-0
Benefits & Contact Info
|
San Diego |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
SCAN Strive (HMO C-SNP) - H5425-097-0
Benefits & Contact Info
|
San Diego |
$24.70 |
$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% Tier 6: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Plus H5619-148 (HMO) - H5619-148-0
Benefits & Contact Info
|
San Diego |
$25.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
|
|
|
Scripps Heart First offered by SCAN Health Plan (HMO C-SNP) - H5425-055-0
Benefits & Contact Info
|
San Diego |
$26.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 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:
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Wellcare Low Premium (HMO) - H0562-130-2
Benefits & Contact Info
|
San Diego |
$29.00 |
$300 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $42.00 Non-Preferred Drug: 44% Specialty Tier: 28% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
AARP Medicare Advantage from UHC CA-0001 (HMO-POS) - H0543-013-0
Benefits & Contact Info
|
San Diego |
$32.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $4.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,300 Browse Formulary |
|
|
|
|
Brand New Day Classic Care II Plan (HMO) - H0838-051-2
Benefits & Contact Info
|
San Diego |
$34.30 |
$50 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 32% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $899 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Senior Advantage Medicare Medi-Cal South P1 (HMO D-SNP) - H8794-001-0
Benefits & Contact Info
|
San Diego |
$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 |
new |
new |
new |
|
Anthem Kidney Care (PPO C-SNP) - H8552-028-0
Benefits & Contact Info
|
San Diego |
$37.10 |
$130 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $1.00 Generic: $6.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Astiva Health C-SNP WOW (HMO C-SNP) - H1993-008-0
Benefits & Contact Info
|
San Diego |
$40.00 |
$545 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $35.00 Non-Preferred Drug: $95.00 Specialty Tier: 25% 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 |
Blue Shield TotalDual Plan (HMO D-SNP) - H2819-001-0
Benefits & Contact Info
|
San Diego |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Brand New Day Embrace Choice Plan (HMO C-SNP) - H0838-040-1
Benefits & Contact Info
|
San Diego |
$41.00 |
$545 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Champion Connect (HMO C-SNP) - H6170-002-0
Benefits & Contact Info
|
San Diego |
$41.00 |
$545 Tier 1 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Champion Select (HMO C-SNP) - H6170-003-0
Benefits & Contact Info
|
San Diego |
$41.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: 25% Preferred Brand: 25% Non-Preferred Brand: 25% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
new |
new |
new |
|
CommuniCare Advantage (HMO D-SNP) - H4733-001-0
Benefits & Contact Info
|
San Diego |
$0.00 for people who qualify for both Medicare and Medicaid. |
$0 for people who qualify for both Medicare and Medicaid. |
No additional gap coverage, only the Donut Hole Discount | Tier 1: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
new |
new |
|
AARP Medicare Advantage from UHC CA-0035 (PPO) - H0294-043-0
Benefits & Contact Info
|
San Diego |
$45.00 |
$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 | $4,500 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 H5525-076 (PPO) - H5525-076-0
Benefits & Contact Info
|
San Diego |
$51.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $2.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
|
Blue Shield Select (PPO) - H4937-002-0
Benefits & Contact Info
|
San Diego |
$57.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,200 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Sharp Direct Advantage Platinum Card (HMO) - H5386-004-0
Benefits & Contact Info
|
San Diego |
$57.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
AARP Medicare Advantage from UHC CA-0007 (HMO-POS) - H0543-060-0
Benefits & Contact Info
|
San Diego |
$61.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $4.00 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 |
|
|
|
|
Scripps Signature offered by SCAN Health Plan (HMO) - H5425-004-0
Benefits & Contact Info
|
San Diego |
$74.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $3.00 Preferred Brand: $37.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% Select Care Drugs: $11.00
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Choice Plan (PPO) - H5521-053-0
Benefits & Contact Info
|
San Diego |
$77.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|