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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Health Alliance Medicare Companion HMO (HMO) - H3471-003-0 Benefit Details |
Chelan | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
new | new | new | |||||||||
Soundpath Health Peak + Rx (HMO) - H9302-011-0 Benefit Details |
Chelan | $0.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $18.00 Preferred Brand: $36.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | $5,900 Browse Formulary | |||||
Soundpath Health Alpine (HMO) - H9302-004-0 Benefit Details |
Chelan | $28.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $2,250 | ||||||
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 | |||||||||
Community HealthFirst MA Special Needs Plan (HMO SNP) - H5826-005-0 Benefit Details |
Chelan | $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% | n/a Browse Formulary | |||||
Health Alliance Medicare Companion HMO Rx (HMO) - H3471-001-0 Benefit Details |
Chelan | $37.00 | $100 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: tbd | $3,400 Browse Formulary | |||||
new | new | new | |||||||||
Soundpath Health Pinnacle + Rx (HMO) - H9302-010-0 Benefit Details |
Chelan | $60.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Non-Preferred Generic: $18.00 Preferred Brand: $36.00 Non-Preferred Brand: $60.00 Specialty Tier: 25% | $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 | |||||||||
Community HealthFirst MA Pharmacy Plan (HMO) - H5826-009-0 Benefit Details |
Chelan | $77.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $10.00 Preferred Brand: $50.00 Specialty Tier: 33% | $3,400 Browse Formulary | |||||
Health Alliance Medicare Companion Plus HMO Rx (HMO) - H3471-002-0 Benefit Details |
Chelan | $80.00 | $60 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: tbd | $2,400 Browse Formulary | |||||
new | new | new | |||||||||
Soundpath Health Charter + Rx (HMO) - H9302-003-0 Benefit Details |
Chelan | $129.00 | $0 | Some Generics | Preferred Generic: $6.00 Non-Preferred Generic: $18.00 Preferred Brand: $36.00 Non-Preferred Brand: $60.00 Specialty Tier: 33% | $2,500 Browse Formulary | |||||
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