2014 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
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 |
|||||||||
AARP MedicareComplete Essential (HMO) - H1286-003-0 Benefit Details |
Spokane | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 | ||||||
AARP MedicareComplete Plan 1 (HMO) - H1286-002-0 Benefit Details |
Spokane | $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% | $5,500 Browse Formulary | |||||
Community HealthFirst MA Extra Plan (HMO) - H5826-010-0 Benefit Details |
Spokane | $0.00 | $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 | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Community HealthFirst MA Plan (HMO) - H5826-006-0 Benefit Details |
Spokane | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Humana Gold Plus H2012-039 (HMO) - H2012-039-0 Benefit Details |
Spokane | $0.00 | $0 | Few Generics, Few Brands | Preferred Generic: $4.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,400 Browse Formulary | |||||
HumanaChoice H6609-070 (PPO) - H6609-070-0 Benefit Details |
Spokane | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Premera Blue Cross Medicare Advantage (HMO) - H7245-001-0 Benefit Details |
Spokane | $0.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Injectable Drugs: 33% Specialty Tier: 33% | $5,900 Browse Formulary | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
UnitedHealthcare Nursing Home Plan (HMO SNP) - H5008-001-0 Benefit Details |
Spokane | $27.80 | $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 | |||||
AARP MedicareComplete Plan 2 (HMO) - H1286-009-0 Benefit Details |
Spokane | $29.00 | $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% | $4,200 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 Plus SNP-DE H2012-095 (HMO SNP) - H2012-095-0 Benefit Details |
Spokane | $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 | |||||
UnitedHealthcare Dual Complete (HMO SNP) - H5008-002-0 Benefit Details |
Spokane | $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 | |||||
Premera Blue Cross Medicare Advantage (HMO-POS) - H7245-002-0 Benefit Details |
Spokane | $34.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $9.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Injectable Drugs: 33% Specialty Tier: 33% | $5,000 Browse Formulary | |||||
new | 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 | |||||||||
Community HealthFirst MA Pharmacy Plan (HMO) - H5826-008-0 Benefit Details |
Spokane | $34.80 | $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 | |||||
Community HealthFirst MA Special Needs Plan (HMO SNP) - H5826-005-0 Benefit Details |
Spokane | $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 | |||||
Molina Medicare Options Plus (HMO SNP) - H5823-006-0 Benefit Details |
Spokane | $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% | 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 | |||||||||
Asuris TruAdvantage Basic (PPO) - H5010-001-0 Benefit Details |
Spokane | $69.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,400 | ||||||
Group Health Cooperative Clear Care Vital (HMO) - H5050-013-0 Benefit Details |
Spokane | $78.00 | $310 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $12.00 Preferred Brand: $20.00 Non-Preferred Brand: 50% | $3,500 Browse Formulary | |||||
Premera Blue Cross Medicare Advantage Plus (HMO) - H7245-003-0 Benefit Details |
Spokane | $82.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Injectable Drugs: 33% Tier 6: 33% | $4,000 Browse Formulary | |||||
new | 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 | |||||||||
Asuris TruAdvantage + Rx Classic (PPO) - H5010-002-0 Benefit Details |
Spokane | $85.00 | $225 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $7.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 27% | $3,400 Browse Formulary | |||||
HumanaChoice H6609-013 (PPO) - H6609-013-0 Benefit Details |
Spokane | $90.00 | $300 | Few Generics, Few Brands | Preferred Generic: $4.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 25% | $6,700 Browse Formulary | |||||
Group Health Cooperative Clear Care Basic (HMO) - H5050-001-0 Benefit Details |
Spokane | $99.00 | 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 | |||||||||
Premera Blue Cross Medicare Advantage Plus (HMO-POS) - H7245-004-0 Benefit Details |
Spokane | $122.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Non-Preferred Generic: $8.00 Preferred Brand: $35.00 Non-Preferred Brand: $80.00 Injectable Drugs: 33% Tier 6: 33% | $2,800 Browse Formulary | |||||
new | new | new | Higher cost-sharing at standard network pharmacies. Details: | ||||||||
HumanaChoice H6609-073 (PPO) - H6609-073-0 Benefit Details |
Spokane | $205.00 | $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 | |||||
Asuris TruAdvantage + Rx Enhanced (PPO) - H5010-004-0 Benefit Details |
Spokane | $207.00 | $0 | Many Generics | Preferred Generic: $5.00 Non-Preferred Generic: $33.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $2,800 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Group Health Cooperative Clear Care Essential (HMO) - H5050-009-0 Benefit Details |
Spokane | $207.00 | $250 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $15.00 Preferred Brand: $22.00 Non-Preferred Brand: 50% | $3,000 Browse Formulary | |||||
Group Health Cooperative Clear Care Key (HMO) - H5050-014-0 Benefit Details |
Spokane | $294.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $5.00 Non-Preferred Generic: $15.00 Preferred Brand: $23.00 Non-Preferred Brand: 50% | $2,500 Browse Formulary | |||||
Group Health Cooperative Clear Care Optimal (HMO) - H5050-004-0 Benefit Details |
Spokane | $328.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $4.00 Non-Preferred Generic: $20.00 Preferred Brand: $25.00 Non-Preferred Brand: 50% | $2,000 Browse Formulary | |||||
|