2014 Medicare Prescription Plans in Manitowoc county Wisconsin



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The 2018 Medicare Part D Plans in Manitowoc County Wisconsin.



2014 Medicare Part-D Plans in Manitowoc county Wisconsin



(Click the Plan Name for More Details)
Plan Name Type Monthly Premium Deductible Gap Full LIS Plan Rating
Return to Counties In Wisconsin
AARP MedicareRx Enhanced (PDP)
(S5921-073)
Enhanced $113.60 $0 Some Generics, Some Brands No
AARP MedicareRx Preferred (PDP)
(S5820-015)
Enhanced $43.70 $0 No Gap Coverage No
AARP MedicareRx Saver Plus (PDP)
(S5921-361)
Basic $23.80 $310.00 No Gap Coverage Yes
Aetna CVS/pharmacy Prescription Drug Plan (PDP)
(S5810-050)
Basic $33.90 $310.00 No Gap Coverage Yes
Aetna Medicare Rx Premier (PDP)
(S5810-186)
Enhanced $131.30 $0 Few Generics No
Blue MedicareRx Plus (PDP)
(S5596-057)
Enhanced $57.20 $0 Some Generics No
Blue MedicareRx Premier (PDP)
(S5596-058)
Enhanced $101.70 $0 Some Generics, Some Brands No
Blue MedicareRx Standard (PDP)
(S5596-056)
Basic $30.50 $310.00 No Gap Coverage Yes
Cigna Medicare Rx Secure (PDP)
(S5617-223)
Basic $31.70 $310.00 No Gap Coverage Yes
Cigna Medicare Rx Secure-Max (PDP)
(S5617-233)
Enhanced $137.00 $0 Many Generics, Some Brands No
Cigna Medicare Rx Secure-Xtra (PDP)
(S5617-261)
Enhanced $71.60 $0 No Gap Coverage No
Cigna-HealthSpring Rx -Reg 16 (PDP)
(S5932-015)
Basic $38.20 $310.00 No Gap Coverage Yes
EnvisionRxPlus Silver (PDP)
(S7694-016)
Basic $36.40 $310.00 No Gap Coverage Yes
Express Scripts Medicare - Choice (PDP)
(S5660-186)
Enhanced $84.70 $0 No Gap Coverage No
Express Scripts Medicare - Value (PDP)
(S5660-118)
Basic $47.20 $310.00 No Gap Coverage No
First Health Part D Essentials (PDP)
(S5768-083)
Basic $53.00 $310.00 No Gap Coverage No
First Health Part D Premier Plus (PDP)
(S5670-084)
Enhanced $108.30 $0 Some Generics, Some Brands No
First Health Part D Value Plus (PDP)
(S5768-139)
Enhanced $50.50 $0 No Gap Coverage No
HealthMarkets Value Rx (PDP)
(S0128-017)
Basic $33.70 $310.00 No Gap Coverage YesToo New
Humana Enhanced (PDP)
(S5884-074)
Enhanced $45.90 $0 Few Brands No
Humana Preferred Rx Plan (PDP)
(S5884-139)
Basic $22.80 $310.00 No Gap Coverage Yes
Humana Walmart Rx Plan (PDP)
(S5884-162)
Enhanced $12.60 $310.00 No Gap Coverage No
Symphonix Value Rx (PDP)
(S0522-036)
Basic $34.40 $310.00 No Gap Coverage YesToo New
Transamerica MedicareRx Choice (PDP)
(S9579-048)
Enhanced $59.90 $0 No Gap Coverage No
Transamerica MedicareRx Classic (PDP)
(S9579-015)
Basic $51.70 $310.00 No Gap Coverage No
United American - Select (PDP)
(S5755-087)
Basic $33.60 $310.00 No Gap Coverage Yes
WPS MedicareRx Plan 1 (PDP)
(S5753-006)
Basic $43.00 $170.00 No Gap Coverage No
WPS MedicareRx Plan 2 (PDP)
(S5753-007)
Enhanced $102.10 $0 Many Generics No


Medicare Advantage Plans in Manitowoc county Wisconsin

Plan Name Type Premium C+D Part D
Deductible
Drug Benefit Type Gap Max Out of Pocket Overall Rating
AARP MedicareComplete (HMO)
(H5253-011)
Local HMO $0 $0 Enhanced No Gap Coverage $4,200
Anthem Medicare Preferred Core (PPO)
(H4036-004)
Local PPO $26.00 $60.00 Enhanced No Gap Coverage $4,000
Care Improvement Plus Medicare Advantage (PPO)
(H0294-004)
Local PPO $0 $0 Enhanced No Gap Coverage $6,700 NA
Humana Gold Choice H8145-006 (PFFS)
(H8145-006)
PFFS $82.00 $0 Enhanced Few Generics, Few Brands N/A
Humana Gold Choice H8145-153 (PFFS)
(H8145-153)
PFFS * $24.00 N/A
Humana Gold Plus H6622-001 (HMO)
(H6622-001)
Local HMO $0 $0 Enhanced Few Generics, Few Brands $4,900
HumanaChoice H5216-003 (PPO)
(H5216-003)
Local PPO $42.00 $0 Enhanced Few Generics, Few Brands $6,700
HumanaChoice R5826-009 P (Regional PPO)
(R5826-009)
Regional PPO $112.00 $310.00 Basic No Gap Coverage $6,700
HumanaChoice R5826-023 P (Regional PPO)
(R5826-023)
Regional PPO * $0 $4,500
Network PlatinumPlus (PPO)
(H5215-001)
Local PPO * $46.00 $2,800
Network PlatinumPlus Pharmacy (PPO)
(H5215-002)
Local PPO $87.00 $0 Enhanced Many Generics $2,800
Network PlatinumPremier (PPO)
(H5215-006)
Local PPO * $150.00 $2,200
Network PlatinumPremier Pharmacy (PPO)
(H5215-005)
Local PPO $227.00 $0 Enhanced Many Generics $2,200
Network PlatinumSelect (PPO)
(H5215-008)
Local PPO $0 $0 Enhanced No Gap Coverage $3,100
Today's Options Premier 900 (PFFS)
(H6169-013)
PFFS * $52.00 N/A
Today's Options Premier Plus 550A (PFFS)
(H6169-024)
PFFS $159.00 $0 Enhanced No Gap Coverage $5,000
Today's Options Premier Plus 950D (PFFS)
(H6169-033)
PFFS $99.00 $100.00 Basic No Gap Coverage N/A


Medicare Special Needs Plans in Manitowoc county Wisconsin

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Care Improvement Plus Dual Advantage (PPO SNP)
(H0294- 006)
Local PPO $34.30 $310.00 No Gap Coverage Dual-EligibleNA
Care Improvement Plus Gold Rx (PPO SNP)
(H0294- 002)
Local PPO $0 $0 No Gap Coverage Chronic or Disabling ConditionNA
iCare Medicare Plan (HMO SNP)
(H2237- 001)
Local HMO $37.00 $310.00 No Gap Coverage Dual-Eligible
NetworkCares (PPO SNP)
(H5215- 007)
Local PPO $37.00 $0 No Gap Coverage Dual-Eligible
UnitedHealthcare Nursing Home Plan (HMO-POS SNP)
(H5253- 007)
Local HMO $37.00 $310.00 No Gap Coverage Institutional


Source: CMS.

Plans as of September 3, 2013.

Plans are subject to change as contracts are finalized.

Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.



Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescrition Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

* Plan Type Indicates plan does not offer Part D drug coverage.

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your plan for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type

Enhanced Alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.

GAP

Coverage gap ("donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. (Unless you get the low-income subsidy) Once you reach the coverage gap in 2014, you will pay 47.5% of the plan's cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail.

Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows:

  • All: 100% of formulary drugs are covered through the gap
  • Many: 65% to 100% of formulary drugs are covered through the gap
  • Some: 10% to 65 % of formulary drugs are covered through the gap
  • Few: 0% to 10% of formulary drugs are covered through the gap (and must also be >15 "brand" products covered through the gap)
  • No Gap Coverage: 0% of formulary drugs are covered through the gap (or 15 "brand" products covered through the gap)
  • All Formulary Drugs: cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit)

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

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