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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-- This plan not offered in 2011 -- |
H5820 -002 -0 | |||||||||||
2012 Any, Any, Any Gold (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $45.00 | $45.00 | 3,148 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H5820 -026 -0 | |||||||||||
2012 Any, Any, Any Gold MA Only (PFFS) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Today's Options Premier 800 (PFFS) | $28.00 | $6,700 | No Rx Coverage | H3333 -039 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 Today's Options Premier 400 (PFFS) | $28.00 | $6,700 | 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 Today's Options Premier 850F powered by CCRx (PFFS) | $89.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | H3333 -057 -0 | $4.00 | $40.00 | $80.00 | $80.00 | n/a | ||
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2012 Today's Options Premier Plus 450B (PFFS) | $64.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
-- This plan not offered in 2011 -- |
H3333 -164 -0 | |||||||||||
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2012 Today's Options Premier 200 (PFFS) | $75.00 | $3,250 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H3333 -166 -0 | |||||||||||
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2012 Today's Options Premier Plus 250A (PFFS) | $148.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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 Any, Any, Any Gold (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -011 -0 | $4.00 | $15.00 | $45.00 | $45.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Any, Any, Any Gold MA Only (PFFS) | $0.00 | $6,700 | No Rx Coverage | H5820 -029 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Any, Any, Any Platinum (PFFS) | $65.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -008 -0 | 0% | $3.00 | $35.00 | $35.00 | 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 e-Any, Any, Any Gold Direct (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -033 -0 | $6.00 | $15.00 | $45.00 | $45.00 | n/a | ||
-- This plan not offered in 2012 -- |
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