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 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
2011 Humana Gold Choice H8145-126 (PFFS) | $0.00 | $5,000 | No Rx Coverage | H8145 -126 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 Humana Gold Choice H8145-126 (PFFS) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | 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 Texas Community Care - Plus (HMO) | $0.00 | $4,950 | $0 | Some Generics | H4529 -014 -0 | $3.00 | $15.00 | $45.00 | $45.00 | n/a | ||
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2012 Texas Community Care - Plus (HMO) | $0.00 | $4,950 | $0 | Some Generics | tbd | |||||||
2011 Texas Community Care - Dual Plus (HMO SNP) | $30.40 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H4529 -031 -0 | n/a | ||||||
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2012 Texas Community Care - Dual Plus (HMO SNP) | $28.50 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $30.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -011 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $30.00 | n/a | $215 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 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 Care Improvement Plus Silver Rx (Regional PPO SNP) | $30.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 Care Improvement Plus Silver Rx (Regional PPO SNP) | $30.00 | n/a | $165 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
2011 HumanaChoice R5826-012 (Regional PPO) | $51.00 | $5,000 | $0 | Few Generics, Few Brands |
R5826 -012 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
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2012 HumanaChoice R5826-012 (Regional PPO) | $54.00 | $5,000 | $0 | Few Generics, Few Brands | $7.00 | $42.00 | $82.00 | $82.00 | 3,798 2012 Formulary | |||
2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $47.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -012 -0 | $9.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 Care Improvement Plus Medicare Advantage (Regional PPO) | $59.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $45.00 | $95.00 | $95.00 | 3,159 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 Humana Gold Choice H8145-084 (PFFS) | $76.00 | $4,500 | $0 | Few Generics, Few Brands |
H8145 -084 -0 | $6.00 | $38.00 | $80.00 | $80.00 | n/a | ||
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2012 Humana Gold Choice H8145-084 (PFFS) | $79.00 | $5,000 | $0 | Few Generics, Few Brands | $6.00 | $38.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
2011 Sterling Basic (PFFS) | $9.00 | $5,000 | No Rx Coverage | H5006 -018 -4 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Sterling Option I (PFFS) | $19.00 | $3,000 | No Rx Coverage | H5006 -014 -1 | This plan does NOT include Prescription Drug coverage. | |||||||
-- 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 Option II (PFFS) | $30.70 | $4,000 | $200 | No additional gap coverage, only the Donut Hole Discount | H5006 -017 -4 | $4.00 | $18.00 | $40.00 | $40.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Today's Options Premier 800 (PFFS) | $90.00 | $6,700 | No Rx Coverage | H5421 -057 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Today's Options Premier 850F powered by CCRx (PFFS) | $100.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | H5421 -075 -0 | $4.00 | $40.00 | $80.00 | $80.00 | 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 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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2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $47.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -012 -0 | $9.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 HumanaChoice R5826-012 (Regional PPO) | $51.00 | $5,000 | $0 | Few Generics, Few Brands |
R5826 -012 -0 | $7.00 | $40.00 | $80.00 | $80.00 | 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 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $30.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -011 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 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 Care Improvement Plus Silver Rx (Regional PPO SNP) | $30.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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