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 Any, Any, Any Gold (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -002 -0 | $4.00 | $15.00 | $45.00 | $45.00 | n/a | ||
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 | |||
2011 Any, Any, Any Gold MA Only (PFFS) | $0.00 | $6,700 | No Rx Coverage | H5820 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Any, Any, Any Gold MA Only (PFFS) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H0084 -004 -0 | |||||||||||
2012 Care Improvement Plus Gold Rx (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 | |||
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 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 | ||
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 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. | ||||||||
2011 Today's Options Premier 800 (PFFS) | $0.00 | $6,700 | No Rx Coverage | H5421 -046 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Today's Options Premier 400 (PFFS) | $0.00 | $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 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. | ||||||||
2011 Care Improvement Plus Medicare Advantage (PPO) | $9.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H0084 -001 -0 | $10.00 | $43.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Medicare Advantage (PPO) | $15.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $43.00 | $95.00 | $95.00 | 3,159 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 | |||
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 -- |
H5006 -018 -22 | |||||||||||
-- | ||||||||||||
2012 WindsorSterling Silver Access Plan (PFFS) | $29.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H0084 -005 -0 | |||||||||||
2012 Care Improvement Plus Dual Advantage (PPO SNP) | $30.00 | n/a | $195 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
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 | ||
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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-- This plan not offered in 2011 -- |
H0084 -003 -0 | |||||||||||
2012 Care Improvement Plus Silver Rx (PPO SNP) | $30.00 | n/a | $210 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
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 | ||
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 | |||
-- This plan not offered in 2011 -- |
H5421 -206 -0 | |||||||||||
2012 Today's Options Premier 200 (PFFS) | $35.00 | $3,250 | 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 850B powered by CCRx (PFFS) | $39.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H5421 -070 -0 | $4.00 | $35.00 | $65.00 | $65.00 | n/a | ||
2012 Today's Options Premier Plus 450B (PFFS) | $41.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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 | ||
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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-- This plan not offered in 2011 -- |
H5006 -017 -22 | |||||||||||
-- | ||||||||||||
2012 WindsorSterling Gold Access Plan (PFFS) | $59.00 | $4,000 | $50 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $34.00 | $34.00 | 2,536 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H2944 -201 -0 | |||||||||||
2012 Humana Gold Choice H2944-201 (PFFS) | $79.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H5421 -212 -0 | |||||||||||
2012 Today's Options Premier Plus 250A (PFFS) | $98.00 | $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 Humana Gold Choice H2944-024 (PFFS) | $86.00 | $5,000 | $0 | Few Generics, Few Brands | H2944 -024 -0 | $6.00 | $38.00 | $80.00 | $80.00 | n/a | ||
2012 Humana Gold Choice H2944-024 (PFFS) | $119.00 | $5,000 | $0 | Few Generics, Few Brands | $6.00 | $38.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
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 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 |
||||||
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 e-Any, Any, Any Gold Direct (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -032 -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 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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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 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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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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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 |
||||||
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 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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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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