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 AARP MedicareComplete Plus Plan 1 (HMO-POS) | $0.00 | $2,940 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -025 -0 | $5.00 | $45.00 | $85.00 | $85.00 | n/a | ||
2012 AARP MedicareComplete Plus Plan 1 (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $45.00 | $45.00 | 3,614 2012 Formulary | |||
2011 Advantra Platinum (PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H1608 -001 -0 | $5.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 Advantra Platinum (PPO) | $0.00 | $3,300 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $40.00 | $80.00 | $80.00 | 3,171 2012 Formulary | |||
2011 Advantra Silver (HMO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H1609 -001 -0 | $5.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 Advantra Silver (HMO) | $0.00 | $3,300 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $40.00 | $80.00 | $80.00 | 3,171 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 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 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 Evercare Plan DH-POS (HMO-POS SNP) | $35.90 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2803 -012 -0 | n/a | ||||||
2012 UnitedHealthcare Dual Complete (HMO-POS SNP) | $28.20 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 3,614 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 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 | |||
2011 AARP MedicareComplete Plan 2 (HMO) | $85.00 | $2,900 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -015 -0 | $5.00 | $32.00 | $65.00 | $65.00 | n/a | ||
2012 AARP MedicareComplete Plan 2 (HMO) | $85.00 | $3,500 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $38.00 | $38.00 | 3,614 2012 Formulary | |||
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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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 H5868-007 (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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