2011 / 2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
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 |
||||||
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 AB Basic Plan (Cost) | $25.00 | $-1 | No Rx Coverage | H0602 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 WINhealth Partners Green Plan (Cost) | $7.00 | $5,000 | No Rx Coverage | H0602 -044 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
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 WINhealth Partners Green Plan + Rx (Cost) | $41.90 | $5,000 | $115 | No additional gap coverage, only the Donut Hole Discount | H0602 -045 -0 | $2.00 | $9.25 | $40.00 | $40.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 WINhealth Partners Standard Plan (Cost) | $65.00 | $-1 | No Rx Coverage | H0602 -013 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 WINhealth Partners Standard Plan + Rx (Cost) | $116.70 | $-1 | $0 | No additional gap coverage, only the Donut Hole Discount | H0602 -023 -0 | $10.00 | $10.00 | $40.00 | $40.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
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 -- |
||||||||||||
|