2014 Medicare Prescription Plans in Santa Clara county California



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The 2017 Medicare Part D Plans in Santa Clara County California.



2014 Medicare Part-D Plans in Santa Clara county California



(Click the Plan Name for More Details)
Plan Name Type Monthly Premium Deductible Gap Full LIS Plan Rating
Return to Counties In California
AARP MedicareRx Enhanced (PDP)
(S5921-003)
Enhanced $112.80 $0 Some Generics, Some Brands No
AARP MedicareRx Preferred (PDP)
(S5820-031)
Enhanced $51.10 $0 No Gap Coverage No
AARP MedicareRx Saver Plus (PDP)
(S5921-376)
Basic $26.00 $310.00 No Gap Coverage Yes
Aetna CVS/pharmacy Prescription Drug Plan (PDP)
(S5810-066)
Basic $49.40 $310.00 No Gap Coverage No
Aetna Medicare Rx Premier (PDP)
(S5810-202)
Enhanced $147.00 $0 Few Generics No
Blue Cross MedicareRx Gold (PDP)
(S5596-035)
Enhanced $108.80 $0 Some Generics, Some Brands No
Blue Cross MedicareRx Plus (PDP)
(S5596-034)
Enhanced $66.10 $0 Some Generics No
Blue Cross MedicareRx Standard (PDP)
(S5596-033)
Basic $30.20 $310.00 No Gap Coverage No
Blue Shield Medicare Basic Plan (PDP)
(S2468-003)
Basic $42.80 $310.00 No Gap Coverage No
Blue Shield Medicare Enhanced Plan (PDP)
(S2468-004)
Enhanced $74.40 $0 No Gap Coverage No
Cigna Medicare Rx Secure (PDP)
(S5617-158)
Basic $51.90 $310.00 No Gap Coverage No
Cigna Medicare Rx Secure-Max (PDP)
(S5617-243)
Enhanced $114.80 $0 Many Generics, Some Brands No
Cigna Medicare Rx Secure-Xtra (PDP)
(S5617-277)
Enhanced $57.80 $0 No Gap Coverage No
Cigna-HealthSpring Rx -Reg 32 (PDP)
(S5932-031)
Basic $44.10 $310.00 No Gap Coverage No
EnvisionRxPlus Silver (PDP)
(S7694-032)
Basic $27.20 $310.00 No Gap Coverage Yes
Express Scripts Medicare - Choice (PDP)
(S5660-202)
Enhanced $70.50 $0 No Gap Coverage No
Express Scripts Medicare - Value (PDP)
(S5660-134)
Basic $62.10 $310.00 No Gap Coverage No
First Health Part D Essentials (PDP)
(S5768-082)
Basic $60.70 $310.00 No Gap Coverage No
First Health Part D Premier Plus (PDP)
(S5674-059)
Enhanced $105.80 $0 Some Generics, Some Brands No
First Health Part D Value Plus (PDP)
(S5768-155)
Enhanced $41.60 $0 No Gap Coverage No
HealthMarkets Value Rx (PDP)
(S0128-033)
Basic $24.50 $310.00 No Gap Coverage YesToo New
Humana Enhanced (PDP)
(S5884-030)
Enhanced $51.20 $0 Few Brands No
Humana Preferred Rx Plan (PDP)
(S5884-114)
Basic $22.80 $310.00 No Gap Coverage Yes
Humana Walmart Rx Plan (PDP)
(S5884-178)
Enhanced $12.60 $310.00 No Gap Coverage No
Symphonix Rite Aid Value Rx (PDP)
(S0522-034)
Basic $23.80 $310.00 No Gap Coverage YesToo New
Transamerica MedicareRx Choice (PDP)
(S9579-064)
Enhanced $57.50 $0 No Gap Coverage No
Transamerica MedicareRx Classic (PDP)
(S9579-031)
Basic $46.90 $310.00 No Gap Coverage No
United American - Enhanced (PDP)
(S5755-035)
Enhanced $70.90 $60.00 No Gap Coverage No
United American - Select (PDP)
(S5755-103)
Basic $25.70 $310.00 No Gap Coverage Yes
WellCare Classic (PDP)
(S5967-169)
Basic $22.40 $0 No Gap Coverage Yes
WellCare Extra (PDP)
(S5967-203)
Enhanced $57.70 $0 No Gap Coverage No


Medicare Advantage Plans in Santa Clara county California

Plan Name Type Premium C+D Part D
Deductible
Drug Benefit Type Gap Max Out of Pocket Overall Rating
AARP MedicareComplete SecureHorizons (HMO)
(H0543-029)
Local HMO $107.00 $0 Basic No Gap Coverage $5,900
Blue Shield 65 Plus (HMO)
(H0504-032)
Local HMO $0 $0 Enhanced Many Generics $2,900
Care1st AdvantageOptimum Plan (HMO)
(H5928-016)
Local HMO $0 $0 Enhanced Many Generics $3,400
CareMore StartSmart Plus (HMO)
(H0544-021)
Local HMO $0 $0 Enhanced No Gap Coverage $6,700
CareMore Value Plus (HMO)
(H0544-012)
Local HMO $55.00 $0 Enhanced Many Generics $3,400
Citizens Choice Healthplan (HMO)
(H3815-007)
Local HMO $0 $0 Enhanced No Gap Coverage $3,400
Coordinated Choice Plan (HMO)
(H5928-037)
Local HMO $26.30 $310.00 Enhanced Few Generics $3,400
Easy Choice Best Plan (HMO)
(H5087-014)
Local HMO $0 $0 Enhanced Many Generics $6,700
Easy Choice Plus Plan (HMO)
(H5087-002)
Local HMO $28.10 $310.00 Enhanced Call plan for details $6,700
Health Net Ruby Select (HMO)
(H0562-089)
Local HMO $69.00 $0 Enhanced No Gap Coverage $3,400
Health Net Seniority Plus Ruby (HMO)
(H0562-095)
Local HMO $232.00 $0 Enhanced No Gap Coverage $5,000
Humana Gold Plus H0108-034 (HMO)
(H0108-034)
Local HMO $49.00 $0 Enhanced Some Generics, Few Brands $3,400
Humana Gold Plus H0108-037 (HMO)
(H0108-037)
Local HMO $19.00 $0 Enhanced Few Generics, Few Brands $5,000
Humana Gold Plus H0108-040 (HMO)
(H0108-040)
Local HMO $0 $310.00 Basic No Gap Coverage $6,700
Kaiser Permanente Senior Advantage Santa Clara (HMO)
(H0524-039)
Local HMO $72.00 $0 Enhanced All Generics, Few Brands $5,900
SCAN Classic (HMO)
(H5425-020)
Local HMO $76.00 $0 Enhanced No Gap Coverage $5,000


Medicare Special Needs Plans in Santa Clara county California

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Care1st TotalDual Plan (HMO SNP)
(H5928- 025)
Local HMO $28.10 $310.00 Few Generics Dual-Eligible
CareMore Breathe (HMO SNP)
(H0544- 024)
Local HMO $55.00 $0 Many Generics, Few Brands Chronic or Disabling Condition
CareMore Connect (HMO SNP)
(H0544- 041)
Local HMO $0 $310.00 Many Generics Dual-Eligible
CareMore Diabetes (HMO SNP)
(H0544- 025)
Local HMO $55.00 $0 Many Generics, Few Brands Chronic or Disabling Condition
CareMore Heart (HMO SNP)
(H0544- 037)
Local HMO $55.00 $0 Many Generics, Few Brands Chronic or Disabling Condition
Satellite Health Plan (HMO SNP)
(H5765- 001)
Local HMO $25.10 $0 No Gap Coverage Chronic or Disabling ConditionToo New
SCAN Balance (HMO SNP)
(H5425- 050)
Local HMO $76.00 $0 Some Generics, Few Brands Chronic or Disabling Condition
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP)
(H0524- 030)
Local HMO $9.50 $0 No Gap Coverage Dual-Eligible


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