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Medicare Advantage Plans, 2006
By Times Staff Writer
Published October 30, 2005
Phone numbers listed are toll-free.
AETNA GOLDEN MEDICARE BASIC
County: Pinellas
Premium: 0
Doctor copay: $25 for primary, $35 specialist
Drug copay: no drug coverage
Hospital copay: $200 a day for first seven days
Maximum out-of-pocket: none
Contact: 1-800-529-5586
AETNA GOLDEN MEDICARE STANDARD
County: Pinellas
Premium: $70
Doctor copay: $20 for primary, $35 specialist
Drug copay: $250 deductible, then $5 generic, $25 brand up to $2,250 total drug costs; no coverage in gap until out-of-pocket costs total $3,600, then $2 generic, $5 brand
Hospital copay: $100 a day for first seven days
Maximum out-of-pocket: none
Contact: 1-800-529-5586
CAREONE PLAN
Counties: Hillsborough, Pinellas
Premium: none
Doctor copay: none for primary; $20 specialist
Drug copay: none for generics; $40 preferred brands; $75 nonpreferred brands
percent of drugs covered by formulary: 97
Hospital copay: $100 a day for first five days in Hillsborough; $75 a day for first five days in Pinellas
Maximum out-of-pocket: none
Contact: 1-800-531-9030
CAREFREE
Counties: Hillsborough, Pinellas
Premium: none, also refunds $40 per month of Part B charge to member
Doctor copay: none for primary; $10 specialist
Drug copay: no drug coverage
Hospital copay: $200 a day for first seven days
Maximum out-of-pocket: none
Contact: 1-800-531-9030
CAREEXTRA
Counties: Hillsborough, Pinellas
Premium: none
Doctor copay: none for primary; none for specialist
Drug copay: no drug coverage
Hospital copay: $50 a day for first seven days
Maximum out-of-pocket: none
Contact: 1-800-531-9030
CITRUSCARE
Counties: Hillsborough, Pasco, Pinellas
Premium: none
Doctor copay: 0 for primary, $25 specialist
Drug copay: $0 generic, $20 brands, $40 preferred brand
Percent of drugs covered by formulary: 96
Hospital copay: $125 a day for first five days
Maximum out-of-pocket: $1,900 a year
Contact: 1-866-769-1157
HUMANA MEDICARE ADVANTAGE*
Counties: Hernando, Hillsborough, Pasco, PinellasPremium: none
Doctor copay: 0 for primary; $10-$25 specialist
Drug copay: for first $2,250 in drug expenses, copay is 0 for generics and brands, $30 for nonpreferred brands; 25 percent of specialty drugs; after out-of-pocket drug costs of $3,600, members pay $2 for generics and brands; $5 for nonpreferred brands; 5 percent for specialty
Percent of drugs covered by formulary: 97
Hospital copay: $50 a day for first five days; $200 a day for days five-seven
Maximum out-of-pocket: 0 to $2,900
Contact: 1-800-611-2561.
MEDICARE MASTERPIECE
Counties: Hernando, Hillsborough, Pasco, Pinellas
Premium: none, plus refunds to member Part B Medicare deduction of $88.50
Doctor copay: 0 for primary; $10 specialist in Hernando; $15 specialist elsewhere
Drug copay: 0 for generics and formulary brands up to $1,850 a year limit; $15 for nonpreferred brands
Percent of drugs covered by formulary: 96
Hospital stay: $250 a day for first seven days in Hernando; $200 a day elsewhere
Maximum out-of-pocket: $1,700 in Hernando, $2,450 in Hillsborough; $2,400 in Pasco, Pinellas
Contact: 1-866-690-4842
MEDICARE MASTERPIECE PREMIER
County: Hernando
Premium: none
Doctor copay: 0 for primary; $5 specialist
Drug copay: 0 for generics and formulary brands up to $1,900 a year; $15 nonpreferred brands
Percent of drugs covered by formulary: 80
Hospital copay: $100 a day for first 11 days
Maximum out-of-pocket: $1,700
Contact: 1-866-690-4842
MEDICARE MASTERPIECE ULTRA
Counties: Hernando, Hillsborough, Pasco, Pinellas
Premium: $59 in Hernando, $99 in Hillsborough, Pasco, Pinellas
Doctor copay: 0 for primary, $5 specialist in Hernando; $10 elsewhere
Drug copay: 0 for generics and formulary brands up to $1,850 a year; $15 nonpreferred brands
Percent of drugs covered by formulary: 97
Hospital copay: $50 a day for first five days in Hernando; $100 a day for first five days elsewhere
Maximum out-of-pocket: $1,700 in Hernando; $2,400 in Pasco, Pinellas; $2,450 Hillsborough
Contact: 1-866-690-4842
MEDICARE MASTERPIECE PLUS
Counties: Hernando, Hillsborough, Pasco, Pinellas
Premium: 0, plus refunds $50 of Part B premium
Doctor copay: 0 for primary; $10 specialist
Drug copay: $5 generics, $20 brand; $35 nonpreferred brand; $1,900 limit
Percent of drugs covered by formulary: 80
Hospital copay: $300 a day for first seven days
Maximum out-of-pocket: none
Contact: 1-866-690-4842
UNITED HEALTHCARE MEDICARE COMPLETE**
Counties: Hernando, Hillsborough, Pasco, Pinellas
Premium: 0
Doctor copay: $10 for primary, $20 specialist
Drug copay: $3 generics, $28 for formulary brands, $58 for nonformulary; 25 percent copay for specialty drugs
Percent of drugs covered by formulary: 100
Hospital copay: $250 a day in Hillsborough and Pinellas, $295 a day in Pasco, Hernando
Maximum out-of-pocket: $3,600
Contact: 1-800-973-6467
WELLCARE CHOICE***
Counties: Hernando, Hillsborough, Pasco
Premium: 0
Doctor copay: 0 for primary in Hernando, Pinellas; $5 elsewhere; 0-$30 for specialists
Drug copay: 0 for generic; $25-$40 formulary brands; $50-$95 nonformulary brands; generics
Covered in coverage gap percent of drugs covered by formulary: 85
Hospital copay: 0 in Hernando; $50 for first five days in Pinellas; $100 for first five days in Hillsborough and Pasco
Maximum out-of-pocket: not available in Hernando; $3,000 elsewhere
Contact: 1-888-888-9355
WELLCARE VALUE
Counties: Hillsborough, Pasco, Pinellas
Premium: 0
Doctor copay: 0 for primary; 0 for specialist in Pinellas; $20 elsewhere
Drug copay: 0 for generic; $45 formulary brand; $100 nonformulary brand; generics covered in coverage gap in Pinellas only
Percent of drugs covered by formulary: 85
Hospital copay: none
Maximum out-of-pocket: not available in Pinellas; $1,500 elsewhere
Contact: 1-888-888-9355
MEDICARE PPOs
Aetna Golden Choice Standard
County: Pinellas
Monthly premium: $70
Contact: 1-800-529-5586
BluePreferred
Counties: Hillsborough, Pinellas
Monthly premium: $108
Contact: 1-800-876-2227
Universal Freedom (2 plans)
Counties: Hernando, Hillsborough, Pasco, Pinellas
Monthly premium: 0 for basic plan, $59 for enhanced
Contact: not available at press time
HUMANA PPO
Counties: statewide
Monthly premium: 0 with no drug coverage; $20 with 4-tier drug benefit
Contact: 1-800-611-2561
United HealthCare's Medicare Complete Choice Rx****
Counties: statewide
Monthly premium: 0
Contact: 1-800-973-6467
* Humana also offers a Medicare Advantage plan with no drug coverage.
** United HealthCare also offers a special needs HMO and a plan with no drug coverage.
*** WellCare also offers two Medicare Advantage plans for people who qualify under special low-income guidelines.
**** This PPO also available without drug benefit.
[Last modified October 28, 2005, 14:24:36]
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