|
Part C
Plans |
Type |
Premium
|
Drugs |
Doctor
|
Vision |
Dental |
CIGNA Medicare Access Plan One (PFFS)
(H2762 - 012)
CIGNA Medicare Access |
Private Fee for Service |
$0 |
No |
Any Willing Doctor |
Covered |
Covered |
Northeast Community Care - Plus (HMO)
(H5416 - 016)
To be determined |
HMO |
$0 |
Yes |
Plan Doctors Only |
Covered |
Covered |
SecureHorizons MedicareDirect Plan 1
(PFFS)
(H5435 - 001)
SecureHorizons by UnitedHealthcare |
Private Fee for Service |
$0 |
No |
Any Willing Doctor |
Covered |
Not Covered |
Today's Options Value (PFFS)
(H3333 - 039)
Universal American |
Private Fee for Service |
$10.00 |
No |
Any Willing Doctor |
Covered |
Not Covered |
SmartValue Classic (PFFS)
(H1689 - 012)
Anthem Blue Cross and Blue Shield |
Private Fee for Service |
$15.00 |
No |
Any Willing Doctor |
Covered |
Not Covered |
CIGNA Medicare Access Plus RX Plan Two
(PFFS)
(H2762 - 028)
CIGNA Medicare Access |
Private Fee for Service |
$20.00 |
Yes |
Any Willing Doctor |
Covered |
Covered |
SecureHorizons MedicareDirect Rx Plan
51 (PFFS)
(H5435 - 014)
SecureHorizons by UnitedHealthcare |
Private Fee for Service |
$20.00 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
Northeast Community Care - Enhanced
(HMO)
(H5416 - 028)
To be determined |
Private Fee for Service |
$27.00 |
Yes |
Any Willing Doctor |
Covered |
Covered |
Today's Options Value powered by CCRx
(PFFS)
(H3333 - 057)
Universal American |
Private Fee for Service |
$29.00 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
SmartValue Plus (PFFS)
(H1689 - 013)
Anthem Blue Cross and Blue Shield |
Private Fee for Service |
$34.50 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
Today's Options Premier (PFFS)
(H3333 - 033)
Universal American |
Private Fee for Service |
$49.00 |
No |
Any Willing Doctor |
Covered |
Not Covered |
CIGNA Medicare Access Plan Three (PFFS)
(H2762 - 016)
CIGNA Medicare Access |
Private Fee for Service |
$60.00 |
No |
Any Willing Doctor |
Covered |
Covered |
First Seniority Freedom - No Drug
(PFFS)
(H7226 - 006)
Harvard Pilgrim Health Care Inc. |
Private Fee for Service |
$67.00 |
No |
Any Willing Doctor |
Covered |
Not Covered |
Humana Gold Choice H2944-073 (PFFS)
(H2944 - 073)
Humana Insurance Company |
Private Fee for Service |
$80.00 |
Yes |
Any Willing Doctor |
Covered (for an extra cost |
Covered
(for an extra cost |
First Seniority Freedom - Drug (PFFS)
(H7226 - 002)
Harvard Pilgrim Health Care Inc. |
Private Fee for Service |
$87.70 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
CIGNA Medicare Access Plus RX Plan Four
(PFFS)
(H2762 - 036)
CIGNA Medicare Access |
Private Fee for Service |
$90.00 |
Yes |
Any Willing Doctor |
Covered |
Covered |
Today's Options Premier powered by CCRx
(PFFS)
(H3333 - 051)
Universal American |
Private Fee for Service |
92.00 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
Humana Gold Choice H2944-106 (PFFS)
(H2944 - 106)
Humana Insurance Company |
Private Fee for Service |
$105.00 |
Yes |
Any Willing Doctor |
Covered (for an extra cost |
Covered
(for an extra cost |
First Seniority Freedom Plus - Drug
(PFFS)
(H7226 - 001)
Harvard Pilgrim Health Care Inc. |
Private Fee for Service |
$181.10 |
Yes |
Any Willing Doctor |
Covered |
Not Covered |
|
Part C
Plans
|
Drug Gap
Coverage
|
Premium with Gap
Coverage
|
Premium Without
Gap Coverage
|
Northeast Community Care - Plus (HMO)
(H5416-016-0) |
"Some Generics" |
$0 |
$0 |
SmartValue Plus (PFFS)
(H1689-013-0)
Anthem Blue Cross and Blue Shield |
"Many Generics" |
$40.20 |
$34.50 |
Today's Options Premier powered by CCRx
(PFFS)
(H3333-051-0)
Universal American |
"All Generics" |
$108.20 |
$92.00 |
Humana Gold Choice H2944-073 (PFFS)
(H2944-073-0)
Humana Insurance Company |
"Few Generics and
Few Brands" |
$104.70 |
$80.00 |
First Seniority Freedom Plus - Drug
(PFFS)
(H7226-001-0)
Harvard Pilgrim Health Care Inc. |
"All Generics" |
$181.10 |
$241.10 |