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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Community HealthFirst MA Special Needs Plan (HMO SNP) - H5826-005-0 Benefit Details |
Stevens | $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 |
Stevens | $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 | |||||
Community HealthFirst MA Pharmacy Plan (HMO) - H5826-009-0 Benefit Details |
Stevens | $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 | |||||
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 H6609-066 (PPO) - H6609-066-0 Benefit Details |
Stevens | $102.00 | $0 | Few Generics, Few Brands | Preferred Generic: $4.00 Non-Preferred Generic: $6.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $5,100 Browse Formulary | |||||
HumanaChoice H6609-073 (PPO) - H6609-073-0 Benefit Details |
Stevens | $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 | |||||
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