2014 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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AARP MedicareComplete Choice Essential (Regional PPO) - R5287-002-0 Benefit Details |
Duval | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
AARP MedicareComplete Choice Plan 2 (Regional PPO) - R5287-001-0 Benefit Details |
Duval | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Aetna Medicare Value Plan (HMO) - H5414-019-0 Benefit Details |
Duval | $0.00 | $0 | Few Generics | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% Select Care Drugs: $0.00 | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
BlueMedicare HMO LifeTime (HMO) - H1026-040-0 Benefit Details |
Duval | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $4,900 Browse Formulary | |||||
BlueMedicare HMO PrimeTime (HMO) - H1026-054-0 Benefit Details |
Duval | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
BlueMedicare Regional PPO (Regional PPO) - R3332-001-0 Benefit Details |
Duval | $0.00 | $30 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
CareOne (HMO) - H1019-069-0 Benefit Details |
Duval | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Coventry Summit Ideal (HMO) - H5850-007-0 Benefit Details |
Duval | $0.00 | $0 | Many Generics | Preferred Generic: $0.00 Preferred Brand: $30.00 Non-Preferred Brand: $65.00 Specialty Tier: 33% | $5,300 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
Day Break (HMO) - H4199-008-0 Sanctioned Plan |
Duval | $0.00 | $0 | All Generics | Generic: $0.00 Preferred Brand: $20.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Day Light (HMO) - H4199-009-0 Sanctioned Plan |
Duval | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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Humana Gold Plus H1036-081D (HMO) - H1036-081-0 Benefit Details |
Duval | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Humana Gold Plus SNP-DB H1036-175 (HMO SNP) - H1036-175-0 Benefit Details |
Duval | $0.00 | $0 | Some Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-018 (Regional PPO) - R5826-018-0 Benefit Details |
Duval | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
HumanaChoice R5826-074 (Regional PPO) - R5826-074-0 Benefit Details |
Duval | $0.00 | $150 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 29% | $5,900 Browse Formulary | |||||
Simply Level (HMO-POS SNP) - H5471-034-0 Benefit Details |
Duval | $0.00 | $0 | Many Generics, Few Brands | Preferred Generic: $0.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Simply More (HMO-POS) - H5471-033-0 Benefit Details |
Duval | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
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Sunrise (HMO) - H4199-007-0 Sanctioned Plan |
Duval | $0.00 | $0 | All Generics | Generic: $0.00 Preferred Brand: $10.00 Non-Preferred Brand: $40.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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WellCare Advance (HMO) - H1032-037-0 Benefit Details |
Duval | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,700 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
WellCare Value (HMO) - H1032-073-0 Benefit Details |
Duval | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $79.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
WellCare Liberty (HMO SNP) - H1032-124-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $4.00 Preferred Brand: $35.00 Non-Preferred Brand: $88.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
WellCare Access (HMO SNP) - H1032-175-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $7.00 Preferred Brand: $35.00 Non-Preferred Brand: $84.00 Specialty Tier: 25% | 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 |
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Service | Exper. | Cost Info | |||||||||
CareNeeds Plus (HMO SNP) - H1019-072-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
Humana Gold Plus SNP-DE H1036-212 (HMO SNP) - H1036-212-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
Humana Gold Plus SNP-DE H1036-210 (HMO SNP) - H1036-210-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 28% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
CareNeeds (HMO SNP) - H1019-073-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Non-Preferred Generic: $5.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 27% | n/a Browse Formulary | |||||
Coventry Summit Maximum (HMO SNP) - H5850-023-0 Benefit Details |
Duval | $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 | Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $76.00 Specialty Tier: 33% | n/a Browse Formulary | |||||
UnitedHealthcare Nursing Home Plan (PPO SNP) - H5417-001-0 Benefit Details |
Duval | $19.80 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | n/a Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Advantage by Sunshine Health (HMO SNP) - H5190-001-0 Benefit Details |
Duval | $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 | Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Injectable Drugs: $95.00 | n/a Browse Formulary | |||||
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UnitedHealthcare Dual Complete RP (Regional PPO SNP) - R5287-003-0 Benefit Details |
Duval | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | No additional gap coverage, only the Donut Hole Discount | Tier 1: 15% Tier 2: 15% Tier 3: 15% Tier 4: 15% Tier 5: 15% | n/a Browse Formulary | |||||
Simply Complete (HMO SNP) - H5471-032-0 Benefit Details |
Duval | $0.00 for people who qualify for both Medicare and Medicaid. | $0 for people who qualify for both Medicare and Medicaid. | Many Generics | Preferred Generic: $0.00 Non-Preferred Generic: $0.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | n/a Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Aetna Medicare Premier Plan (PPO) - H5521-033-0 Benefit Details |
Duval | $35.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% Select Care Drugs: $0.00 | $6,700 Browse Formulary | |||||
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WellCare Choice (HMO-POS) - H1032-002-0 Benefit Details |
Duval | $46.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Non-Preferred Generic: $10.00 Preferred Brand: $25.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | $6,700 Browse Formulary | |||||
Higher cost-sharing at standard network pharmacies. Details: | |||||||||||
HumanaChoice R5826-005 (Regional PPO) - R5826-005-0 Benefit Details |
Duval | $92.00 | $0 | Few Generics, Few Brands | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $5,700 Browse Formulary | |||||
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