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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BCN Advantage HMO-POS Basic (HMO-POS) - H5883-004-5 Benefit Details |
Wayne | $0.00 | $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% | $4,200 Browse Formulary | |||||
Fidelis Secure Respect (HMO) - H2323-015-0 Benefit Details |
Wayne | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $4,400 Browse Formulary | |||||
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HealthPlus MedicarePlus AdvantageHMO-POS Option 0 (HMO-POS) - H2354-015-0 Benefit Details |
Wayne | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $42.00 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 | |||||||||
HumanaChoice R5826-053 P (Regional PPO) - R5826-053-0 Benefit Details |
Wayne | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
Meridian Prime (HMO) - H5475-002-0 Benefit Details |
Wayne | $0.00 | $310 | 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: $85.00 Specialty Tier: 25% | $4,000 Browse Formulary | |||||
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Medicare Plus Blue PPO Essential (PPO) - H9572-004-6 Benefit Details |
Wayne | $17.50 | $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% | $6,400 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 | |||||||||
UnitedHealthcare Dual Complete (HMO SNP) - H6952-002-0 Benefit Details |
Wayne | $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% Tier 2: 0% Tier 3: 0% Tier 4: 0% Tier 5: 0% | n/a Browse Formulary | |||||
Molina Medicare Options Plus (HMO SNP) - H5926-001-0 Benefit Details |
Wayne | $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 Specialty Tier: 25% | n/a Browse Formulary | |||||
Fidelis Secure Comfort (HMO SNP) - H2323-005-0 Benefit Details |
Wayne | $32.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 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 | |||||||||
Fidelis Secure Freedom (HMO SNP) - H2323-011-0 Benefit Details |
Wayne | $32.50 | $310 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% | n/a Browse Formulary | |||||
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Fidelis Secure Liberty (HMO SNP) - H2323-012-0 Benefit Details |
Wayne | $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% | n/a Browse Formulary | |||||
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HealthPlus MedicarePlus Advantage D-SNP (HMO SNP) - H2354-016-0 Benefit Details |
Wayne | $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% Tier 2: 0% Tier 3: 0% Tier 4: 0% | 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 | |||||||||
McLarenAdvantage (HMO SNP) - H0141-001-0 Benefit Details |
Wayne | $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 Specialty Tier: 25% | n/a Browse Formulary | |||||
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Meridian Advantage Plan of Michigan (HMO SNP) - H5475-001-0 Benefit Details |
Wayne | $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% | n/a Browse Formulary | |||||
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Midwest Advantage (HMO SNP) - H5685-001-0 Benefit Details |
Wayne | $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 Brand: $0.00 | 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 | |||||||||
Total Medicare Plus (HMO SNP) - H1444-001-0 Benefit Details |
Wayne | $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: 25% Non-Preferred Brand: 25% Specialty Tier: 25% | n/a Browse Formulary | |||||
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BCN Advantage HMO-POS Elements (HMO-POS) - H5883-001-5 Benefit Details |
Wayne | $44.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,600 | ||||||
HealthPlus MedicarePlus AdvantagePPO Basic (PPO) - H1595-003-0 Benefit Details |
Wayne | $48.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,500 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 | |||||||||
HAP Senior Plus - Henry Ford (HMO) - H2312-006-0 Benefit Details |
Wayne | $50.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
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Fidelis Secure Premier (HMO) - H2323-016-0 Benefit Details |
Wayne | $52.00 | $0 | Many Generics | Generic: $5.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $4,400 Browse Formulary | |||||
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HAP Senior Plus - Expanded Network (HMO-POS) - H2312-012-0 Benefit Details |
Wayne | $58.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: 33% 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 | |||||||||
PriorityMedicare Value (HMO-POS) - H2320-021-0 Benefit Details |
Wayne | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
BCN Advantage HMO Local (HMO) - H5883-005-0 Benefit Details |
Wayne | $66.00 | $50 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $80.00 Specialty Tier: 30% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Henry Ford (HMO) - H2312-004-0 Benefit Details |
Wayne | $73.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: 27% Specialty Tier: 27% | $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 |
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Service | Exper. | Cost Info | |||||||||
HumanaChoice R5826-006 P (Regional PPO) - R5826-006-0 Benefit Details |
Wayne | $90.00 | $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% | $6,700 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantageHMO-POS Option 1 (HMO-POS) - H2354-001-0 Benefit Details |
Wayne | $98.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $7.00 Preferred Brand: $40.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-007-0 Benefit Details |
Wayne | $99.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: 30% Specialty Tier: 30% | $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 |
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Service | Exper. | Cost Info | |||||||||
Medicare Plus Blue PPO Vitality (PPO) - H9572-002-6 Benefit Details |
Wayne | $99.00 | $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% | $5,400 Browse Formulary | |||||
PriorityMedicare Merit (PPO) - H4875-016-3 Benefit Details |
Wayne | $99.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $4,500 Browse Formulary | |||||
Alliance Medicare PPO (PPO) - H2322-008-0 Benefit Details |
Wayne | $124.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $2.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: 33% Specialty Tier: 33% | $3,401 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 | |||||||||
McLarenAdvantage (HMO) - H0141-002-0 Benefit Details |
Wayne | $128.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $5.00 Preferred Brand: $30.00 Non-Preferred Brand: $70.00 Specialty Tier: 25% | $3,300 Browse Formulary | |||||
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BCN Advantage HMO-POS Classic (HMO-POS) - H5883-002-7 Benefit Details |
Wayne | $130.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $80.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
PriorityMedicare (HMO-POS) - H2320-019-0 Benefit Details |
Wayne | $138.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 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 | |||||||||
Medicare Plus Blue PPO Signature (PPO) - H9572-001-6 Benefit Details |
Wayne | $148.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,400 Browse Formulary | |||||
HealthPlus MedicarePlus AdvantageHMO-POS Option 2 (HMO-POS) - H2354-013-0 Benefit Details |
Wayne | $150.00 | $0 | Many Generics | Generic: $6.00 Preferred Brand: $38.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
PriorityMedicare Select (PPO) - H4875-017-5 Benefit Details |
Wayne | $165.50 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $8.00 Preferred Brand: $40.00 Non-Preferred Brand: $85.00 Specialty Tier: 33% | $3,400 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 | |||||||||
HealthPlus MedicarePlus AdvantagePPO Enhanced (PPO) - H1595-002-0 Benefit Details |
Wayne | $176.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Generic: $6.00 Preferred Brand: $40.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
HAP Senior Plus - Expanded Network (HMO-POS) - H2312-010-0 Benefit Details |
Wayne | $179.00 | $50 | All Generics | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $45.00 Non-Preferred Brand: 31% Specialty Tier: 31% | $3,000 Browse Formulary | |||||
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Alliance Medicare PPO (PPO) - H2322-004-0 Benefit Details |
Wayne | $203.00 | $150 | All Generics | Preferred Generic: $4.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: 29% Specialty Tier: 29% | $3,401 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 | |||||||||
BCN Advantage HMO-POS Prestige (HMO-POS) - H5883-003-5 Benefit Details |
Wayne | $246.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Brand: $75.00 Specialty Tier: 33% | $3,200 Browse Formulary | |||||
Medicare Plus Blue PPO Assure (PPO) - H9572-003-6 Benefit Details |
Wayne | $272.00 | $0 | Some Generics | Preferred Generic: $3.00 Non-Preferred Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
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