2011 / 2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend | ||||||||||||
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Plan Name | Monthly Premium |
Part A&B Maximum Out-Of |
Part D Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Formulary Drugs | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2011 Humana Gold Choice H2944-178 (PFFS) | $0.00 | $5,000 | No Rx Coverage | H2944 -178 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Humana Gold Choice H2944-178 (PFFS) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice H5868-004 (PPO) | $0.00 | $3,400 | No Rx Coverage | H5868 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 HumanaChoice H5868-004 (PPO) | $0.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 SecureHorizons MedicareDirect Essential (PFFS) | $0.00 | $5,200 | No Rx Coverage | H5435 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 UnitedHealthcare MedicareDirect Essential (PFFS) | $0.00 | $6,200 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2011 HumanaChoice H5868-001 (PPO) | $21.00 | $3,400 | $0 | Few Generics, Few Brands |
H5868 -001 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
2012 HumanaChoice H5868-001 (PPO) | $21.00 | $4,000 | $0 | Few Generics, Few Brands | $7.00 | $42.00 | $90.00 | $90.00 | 3,798 2012 Formulary | |||
2011 SecureHorizons MedicareDirect Rx (PFFS) | $20.00 | $5,200 | $0 | No additional gap coverage, only the Donut Hole Discount | H5435 -014 -0 | $6.00 | $45.00 | $88.00 | $88.00 | n/a | ||
2012 UnitedHealthcare MedicareDirect Rx (PFFS) | $28.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,614 2012 Formulary | |||
2011 Humana Gold Choice H2944-004 (PFFS) | $50.00 | $5,000 | $0 | Few Generics, Few Brands |
H2944 -004 -0 | $6.00 | $39.00 | $80.00 | $80.00 | n/a | ||
2012 Humana Gold Choice H2944-004 (PFFS) | $50.00 | $5,000 | $0 | Few Generics, Few Brands | $6.00 | $39.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2011 Today's Options Premier 800 (PFFS) | $60.00 | $6,700 | No Rx Coverage | H5421 -049 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Today's Options Premier 400 (PFFS) | $60.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Today's Options Premier 850E powered by CCRx (PFFS) | $80.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | H5421 -073 -0 | $4.00 | $40.00 | $70.00 | $70.00 | n/a | ||
2012 Today's Options Premier Plus 450D (PFFS) | $82.00 | $6,700 | $50 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 MedicareBlue PPO (Regional PPO) | $71.30 | $3,350 | $310 | No additional gap coverage, only the Donut Hole Discount | R5566 -005 -0 | 13% | 26% | 50% | 50% | n/a | ||
2012 MedicareBlue PPO (Regional PPO) | $84.40 | $3,400 | $155 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $11.00 | $33.00 | $33.00 | 2,766 2012 Formulary | |||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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-- This plan not offered in 2011 -- |
H5421 -209 -0 | |||||||||||
2012 Today's Options Premier 200 (PFFS) | $95.00 | $3,250 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Today's Options Premier 450A powered by CCRx (PFFS) | $142.00 | $3,400 | $150 | Many Generics, Some Brands |
H5421 -067 -0 | $4.00 | $35.00 | $65.00 | $65.00 | n/a | ||
2012 Today's Options Premier Plus 250A (PFFS) | $139.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 HumanaChoice H5868-007 (PPO) | $11.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H5868 -007 -0 | $5.00 | $32.00 | $63.00 | $63.00 | n/a | ||
-- This plan not offered in 2012 -- |
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Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2011 Sterling Basic (PFFS) | $39.00 | $5,000 | No Rx Coverage | H5006 -018 -8 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Sterling Option I (PFFS) | $69.00 | $3,000 | No Rx Coverage | H5006 -014 -5 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Sterling Option II (PFFS) | $90.70 | $4,000 | $200 | No additional gap coverage, only the Donut Hole Discount | H5006 -017 -8 | $4.00 | $18.00 | $40.00 | $40.00 | n/a | ||
-- This plan not offered in 2012 -- |
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Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
||||||
2011 MedicareBlue PPO (Regional PPO) | $71.30 | $3,350 | $310 | No additional gap coverage, only the Donut Hole Discount | R5566 -005 -0 | 13% | 26% | 50% | 50% | n/a | ||
-- This plan not offered in 2012 -- |
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