AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) - H8768-019-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,900 |
|
|
|
|
Aetna Medicare Eagle (PPO) - H5521-286-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,390 |
|
|
|
|
Blue Cross Medicare Advantage Protect (PPO) - H8634-019-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $6,350 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Cigna True Choice Courage Medicare (PPO) - H7849-078-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,900 |
|
|
|
|
Humana USAA Honor (PPO) - H5216-258-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
|
|
|
Humana USAA Honor (PPO) - H5216-355-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Humana USAA Honor (Regional PPO) - R5361-001-0
Benefits & Contact Info
|
Will |
$0.00 |
No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $5,500 |
|
-- |
|
|
AARP Medicare Advantage from UHC IL-0002 (HMO-POS) - H2802-054-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
|
AARP Medicare Advantage Walgreens from UHC IL-0005 (PPO) - H8768-010-0
Benefits & Contact Info
|
Will |
$0.00 |
$195 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $5,700 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 |
Service |
Exper. |
Cost Info |
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) - H2506-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Aetna Medicare Choice (PPO) - H7301-013-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 33%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Duly Prime (PPO) - H5521-314-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,875 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 |
Service |
Exper. |
Cost Info |
Aetna Medicare Prime (HMO-POS) - H3192-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,950 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Aetna Medicare Value (PPO) - H5521-086-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,950 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Basic (HMO) - H3822-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,500 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 |
Service |
Exper. |
Cost Info |
Blue Cross Medicare Advantage Basic Plus (HMO-POS) - H3822-007-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Classic (PPO) - H8634-008-0
Benefits & Contact Info
|
Will |
$0.00 |
$200 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30%
all covered insulin pay $35 or less | $4,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Dental Premier (PPO) - H8634-021-0
Benefits & Contact Info
|
Will |
$0.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $7,550 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 |
Service |
Exper. |
Cost Info |
Blue Cross Medicare Advantage Elite (PPO) - H8634-016-0
Benefits & Contact Info
|
Will |
$0.00 |
$250 Tier 1, 2 and 3 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29%
all covered insulin pay $35 or less | $3,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Health Choice (PPO) - H8634-018-0
Benefits & Contact Info
|
Will |
$0.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $6,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Secure (HMO) - H8547-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,500 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 |
Service |
Exper. |
Cost Info |
Blue Medicare Advantage (Medicare-Medicaid Plan) - H0927-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Cigna Preferred Medicare (HMO) - H4513-085-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna Preferred Savings Medicare (HMO) - H4513-086-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,500 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 |
Service |
Exper. |
Cost Info |
Cigna Premier Medicare (HMO-POS) - H4513-084-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,200 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna True Choice Medicare (PPO) - H7849-002-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Cigna True Choice Savings Medicare (PPO) - H7849-080-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $4.00 Preferred Brand: $45.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,700 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 |
Service |
Exper. |
Cost Info |
Clear Spring Health Community Advantage Plan (HMO) - H3071-002-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,950 Browse Formulary |
|
-- |
|
Higher cost-sharing at standard network pharmacies. Details:
|
Clear Spring Health Essential (HMO C-SNP) - H5454-006-0
Benefits & Contact Info
|
Will |
$0.00 |
$250 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 29%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
-- |
Higher cost-sharing at standard network pharmacies. Details:
|
Clear Spring Health Essential (HMO) - H5454-002-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,900 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 |
Service |
Exper. |
Cost Info |
Devoted CHOICE Illinois (PPO) - H6545-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
new |
new |
|
Devoted CORE Illinois (HMO) - H7151-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,500 Browse Formulary |
|
|
|
|
Devoted GIVEBACK Illinois (HMO) - H7151-003-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,500 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 Community HMO Diabetes and Heart (HMO C-SNP) - H1468-017-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Humana Gold Plus H1468-013 (HMO) - H1468-013-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $2,300 Browse Formulary |
|
|
|
|
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan) - H0336-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0% Tier 4: 0%
all covered insulin pay $35 or less | 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 |
HumanaChoice H5216-251 (PPO) - H5216-251-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,700 Browse Formulary |
|
|
|
|
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan) - H6080-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
all covered insulin pay $35 or less | n/a Browse Formulary |
-- |
-- |
-- |
|
Molina Dual Options (Medicare-Medicaid Plan) - H8046-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Tier 1: 0% Tier 2: 0% Tier 3: 0%
all covered insulin pay $35 or less | 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 |
Molina Medicare Choice Care (HMO) - H2715-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$125 Tier 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $3.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 31% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $8,300 Browse Formulary |
|
new |
new |
|
Wellcare Complete - Giveback (HMO) - H7399-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$500 Tier 1, 2 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare Giveback Open (PPO) - H6713-002-0
Benefits & Contact Info
|
Will |
$0.00 |
$545 Tier 1, 2 and 6 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $5,000 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 |
Service |
Exper. |
Cost Info |
Wellcare No Premium (HMO-POS) - H1416-009-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 45% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,700 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Essential (HMO) - H5779-002-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 46% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Essential Value (HMO) - H5779-009-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 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 |
Service |
Exper. |
Cost Info |
Wellcare No Premium Exclusive (HMO) - H5779-007-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 49% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Open (PPO) - H6713-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 47% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Wellcare No Premium Value (HMO-POS) - H1416-082-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 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 |
Service |
Exper. |
Cost Info |
Zing Choice IL (HMO) - H4624-001-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,850 Browse Formulary |
|
-- |
|
|
Zing Elite Diabetes & Heart IL (HMO C-SNP) - H4624-028-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
|
Zing Essential Wellness Diabetes & Heart IL (HMO C-SNP) - H4624-010-0
Benefits & Contact Info
|
Will |
$0.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Select Care Drugs: $0.00
all covered insulin pay $35 or less | 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 |
Wellcare Assist Compass (HMO) - H1416-023-0
Benefits & Contact Info
|
Will |
$19.50 |
$545 Tier 1 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 45% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | $2,900 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
UHC Nursing Home Plan IL-F002 (HMO-POS I-SNP) - H2802-027-0
Benefits & Contact Info
|
Will |
$21.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
Aetna Medicare Value Plus (PPO) - H7301-014-0
Benefits & Contact Info
|
Will |
$22.00 |
$400 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 27%
all covered insulin pay $35 or less | $4,550 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 |
Service |
Exper. |
Cost Info |
UHC Complete Care IL-001A (PPO C-SNP) - H0271-027-0
Benefits & Contact Info
|
Will |
$23.50 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
|
AARP Medicare Advantage from UHC IL-0001 (HMO-POS) - H2802-025-0
Benefits & Contact Info
|
Will |
$29.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,200 Browse Formulary |
|
|
|
|
HumanaChoice H5216-283 (PPO) - H5216-283-0
Benefits & Contact Info
|
Will |
$30.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,100 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
UHC Nursing Home Plan IL-F001 (PPO I-SNP) - H0710-039-0
Benefits & Contact Info
|
Will |
$30.60 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
|
Longevity Health Plan (HMO I-SNP) - H9590-001-0
Benefits & Contact Info
|
Will |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
|
Provider Partners Illinois Advantage Plan (HMO I-SNP) - H3800-001-0
Benefits & Contact Info
|
Will |
$32.80 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Tier 1: 25%
all covered insulin pay $35 or less | 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 |
Zing Select Diabetes & Heart Complete IL (HMO C-SNP) - H4624-027-0
Benefits & Contact Info
|
Will |
$32.80 |
$545 Tier 1 and 6 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: 25% Preferred Brand: 25% Non-Preferred Drug: 25% Specialty Tier: 25% Select Care Drugs: $0.00
all covered insulin pay $35 or less | n/a Browse Formulary |
|
-- |
|
|
AARP Medicare Advantage from UHC IL-0004 (PPO) - H8768-005-0
Benefits & Contact Info
|
Will |
$34.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,800 Browse Formulary |
|
|
|
|
Aetna Medicare Premier Plus (PPO) - H5521-016-0
Benefits & Contact Info
|
Will |
$34.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,400 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 |
Service |
Exper. |
Cost Info |
Blue Cross Medicare Advantage Premier Plus (HMO-POS) - H3822-008-0
Benefits & Contact Info
|
Will |
$76.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Choice Plus (PPO) - H8634-003-0
Benefits & Contact Info
|
Will |
$77.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $4,500 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice R5361-002 (Regional PPO) - R5361-002-0
Benefits & Contact Info
|
Will |
$97.00 |
$545 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: 24% Non-Preferred Drug: 25% Specialty Tier: 25%
all covered insulin pay $35 or less | $6,700 Browse Formulary |
|
-- |
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
HumanaChoice H5216-013 (PPO) - H5216-013-0
Benefits & Contact Info
|
Will |
$100.00 |
$0 |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $6.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $5,700 Browse Formulary |
|
|
|
|
Blue Cross Medicare Advantage Choice Premier (PPO) - H8634-004-0
Benefits & Contact Info
|
Will |
$135.00 |
$0 |
Yes, some additional gap coverage. | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33%
all covered insulin pay $35 or less | $3,855 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
HumanaChoice H5216-357 (PPO) - H5216-357-0
Benefits & Contact Info
|
Will |
$138.00 |
$545 Tier 1 and 2 exempt |
Yes, some additional gap coverage. | Preferred Generic: $5.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | $1,000 Browse Formulary |
|
|
|
|
Plan Name |
County |
Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
Service |
Exper. |
Cost Info |
Aetna Medicare Enhanced Select (PPO) - H7301-015-0
Benefits & Contact Info
|
Will |
$169.00 |
$300 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 25% Non-Preferred Drug: 40% Specialty Tier: 28%
all covered insulin pay $35 or less | $1,400 Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|
Blue Cross Medicare Advantage Flex (PPO) - H8634-014-0
Benefits & Contact Info
|
Will |
$202.00 |
$545 Tier 1 and 2 exempt |
No additional gap coverage, only the Donut Hole Discount | Preferred Generic: $0.00 Generic: $8.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25%
all covered insulin pay $35 or less | n/a Browse Formulary |
|
|
|
Higher cost-sharing at standard network pharmacies. Details:
|