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 (HMO-POS) | $0.00 | $3,380 | $0 | No additional gap coverage, only the Donut Hole Discount | H2182 -001 -0 | $5.00 | $45.00 | $85.00 | $85.00 | n/a | ||
2012 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $4,250 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $45.00 | $45.00 | 3,614 2012 Formulary | |||
2011 Advantra Elite (HMO) | $13.00 | $3,400 | $0 | Many Generics | H5302 -009 -0 | $4.00 | $37.00 | $69.00 | $69.00 | n/a | ||
2012 Advantra Elite (HMO) | $0.00 | $3,300 | $0 | Many Generics | $4.00 | $40.00 | $78.00 | $78.00 | 3,171 2012 Formulary | |||
2011 Advantra Silver (HMO-POS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5302 -003 -0 | $4.00 | $40.00 | $76.00 | $76.00 | n/a | ||
2012 Advantra Silver (HMO-POS) | $0.00 | $4,375 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $45.00 | $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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-- This plan not offered in 2011 -- |
H4211 -003 -0 | |||||||||||
new | new | new | ||||||||||
2012 Amerivantage Choice + Rx (HMO-POS) | $0.00 | $6,700 | $0 | Some Generics | $4.00 | $6.00 | $45.00 | $45.00 | 3,055 2012 Formulary | |||
2011 Any, Any, Any Gold (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H8098 -001 -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 | H8098 -003 -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. | ||||||||
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 BlueValue Basic (HMO) | $0.00 | $4,500 | $0 | Many Generics | H5422 -006 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 BlueValue Basic (HMO) | $0.00 | $4,500 | $60 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
2011 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -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 R5826-064 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -064 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
2012 HumanaChoice R5826-064 (Regional PPO) | $0.00 | $4,900 | 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 |
||||||
-- This plan not offered in 2011 -- |
H9947 -001 -0 | |||||||||||
new | new | new | ||||||||||
2012 Medicare Preferred Core (PPO) | $0.00 | $4,900 | $60 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H9947 -003 -0 | |||||||||||
new | new | new | ||||||||||
2012 Medicare Preferred Online (PPO) | $0.00 | $6,700 | $60 | Many Generics | $0.00 | $45.00 | $95.00 | $95.00 | 4,453 2012 Formulary | |||
2011 Southeast Community Care - Plus (HMO) | $0.00 | $4,950 | $0 | Some Generics | H5578 -002 -0 | $6.00 | $15.00 | $45.00 | $45.00 | n/a | ||
-- | ||||||||||||
2012 Southeast Community Care - Plus (HMO) | $0.00 | $4,950 | $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 |
||||||
-- This plan not offered in 2011 -- |
H5096 -001 -0 | |||||||||||
new | new | new | ||||||||||
2012 Universal Hassle-Free (PPO) | $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 -- |
H5096 -002 -0 | |||||||||||
new | new | new | ||||||||||
2012 Universal Hassle-Free MA Only (PPO) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 WellCare Value (HMO-POS) | $0.00 | $4,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H1112 -027 -0 | $3.00 | $39.00 | $75.00 | $75.00 | n/a | ||
2012 WellCare Value (HMO-POS) | $0.00 | $4,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $39.00 | $75.00 | $75.00 | 2,506 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 |
||||||
2011 Humana Gold Choice H8145-117 (PFFS) | $15.00 | $6,700 | No Rx Coverage | H8145 -117 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-117 (PFFS) | $15.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 WellCare Access (HMO SNP) | $22.40 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H1112 -006 -0 | $3.00 | $41.00 | $93.00 | $93.00 | n/a | ||
2012 WellCare Access (HMO SNP) | $16.60 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 2,506 2012 Formulary | |||
2011 BlueValue Secure (HMO) | $22.00 | $3,300 | $0 | Many Generics | H5422 -002 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 BlueValue Secure (HMO) | $25.00 | $3,300 | $60 | Many Generics | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 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 |
||||||
2011 Silver Advantage (HMO) | $25.40 | $6,700 | $0 | Many Generics | H5302 -007 -0 | $4.00 | $35.00 | $69.00 | $69.00 | n/a | ||
2012 Silver Advantage (HMO) | $29.60 | $6,500 | $0 | Many Generics | $4.00 | $45.00 | $85.00 | $85.00 | 3,093 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H9988 -017 -0 | |||||||||||
-- | ||||||||||||
2012 Fresenius Health Partners (PPO SNP) | $30.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 2,536 2012 Formulary | |||
2011 HumanaChoice H5214-012 (PPO) | $28.00 | $3,900 | $0 | Few Generics, Few Brands |
H5214 -012 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
2012 HumanaChoice H5214-012 (PPO) | $31.00 | $4,900 | $0 | Few Generics, Few Brands | $7.00 | $44.00 | $84.00 | $84.00 | 3,798 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 |
||||||
-- This plan not offered in 2011 -- |
H4211 -001 -0 | |||||||||||
new | new | new | ||||||||||
2012 Amerivantage Specialty + Rx (HMO SNP) | $31.10 | n/a | $320 | Some Generics | $0.00 | 25% | 25% | 25% | 3,055 2012 Formulary | |||
2011 Care Improvement Plus Silver Rx (Regional PPO SNP) | $34.90 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Silver Rx (Regional PPO SNP) | $33.60 | n/a | $145 | 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 -- |
H9947 -002 -0 | |||||||||||
new | new | new | ||||||||||
2012 Medicare Preferred Premier (PPO) | $40.00 | $3,400 | $60 | Many Generics | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 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 |
||||||
-- This plan not offered in 2011 -- |
H6169 -013 -0 | |||||||||||
-- | -- | -- | ||||||||||
2012 Today's Options Premier 400 (PFFS) | $50.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H5378 -184 -0 | |||||||||||
-- | ||||||||||||
2012 Today's Options Advantage Plus 450F (PPO) | $51.00 | $6,700 | $75 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
-- This plan not offered in 2011 -- |
H9988 -002 -0 | |||||||||||
-- | ||||||||||||
2012 WindsorSterling Gold Plus Plan (PPO) | $55.00 | $4,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $16.00 | $36.00 | $36.00 | 2,536 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 |
||||||
2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $63.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -012 -0 | $9.00 | $43.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Medicare Advantage (Regional PPO) | $70.00 | $6,700 | $230 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
2011 Humana Gold Choice H8145-079 (PFFS) | $70.00 | $5,900 | $0 | Few Generics, Few Brands |
H8145 -079 -0 | $6.00 | $41.00 | $80.00 | $80.00 | n/a | ||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-079 (PFFS) | $70.00 | $5,900 | $0 | Few Generics, Few Brands | $7.00 | $42.00 | $85.00 | $85.00 | 3,798 2012 Formulary | |||
2011 HumanaChoice R5826-077 (Regional PPO) | $69.00 | $5,900 | $150 | No additional gap coverage, only the Donut Hole Discount | R5826 -077 -0 | $6.00 | $35.00 | $70.00 | $70.00 | n/a | ||
-- | ||||||||||||
2012 HumanaChoice R5826-077 (Regional PPO) | $76.00 | $5,900 | $200 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $35.00 | $70.00 | $70.00 | 3,798 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 |
||||||
-- This plan not offered in 2011 -- |
H6169 -051 -0 | |||||||||||
-- | -- | -- | ||||||||||
2012 Today's Options Premier 200 (PFFS) | $80.00 | $3,250 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2011 -- |
H6169 -033 -0 | |||||||||||
-- | -- | -- | ||||||||||
2012 Today's Options Premier Plus 450C (PFFS) | $87.00 | $6,700 | $35 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
-- This plan not offered in 2011 -- |
H5378 -200 -0 | |||||||||||
-- | ||||||||||||
2012 Today's Options Advantage Plus 250A (PPO) | $122.00 | $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 |
||||||
2011 Today's Options Premier 450A powered by CCRx (PFFS) | $142.00 | $3,400 | $150 | Many Generics, Some Brands |
H6169 -024 -0 | $4.00 | $35.00 | $65.00 | $65.00 | n/a | ||
-- | -- | -- | ||||||||||
2012 Today's Options Premier Plus 250A (PFFS) | $147.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 HumanaChoice R5826-004 (Regional PPO) | $59.00 | $5,900 | $0 | Few Generics, Few Brands |
R5826 -004 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 Today's Options Advantage 850B powered by CCRx (PPO) | $59.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H5378 -185 -0 | $4.00 | $35.00 | $65.00 | $65.00 | 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 Today's Options Premier 800 (PFFS) | $55.00 | $6,700 | No Rx Coverage | H6169 -014 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 Today's Options Premier 850E powered by CCRx (PFFS) | $80.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | H6169 -034 -0 | $4.00 | $40.00 | $70.00 | $70.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 Any, Any, Any Platinum (PFFS) | $69.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H8098 -009 -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 e-Any, Any, Any Gold Direct (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H8098 -005 -0 | $6.00 | $15.00 | $45.00 | $45.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 WellCare Advance (HMO) | $0.00 | $3,150 | No Rx Coverage | H1112 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $63.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -012 -0 | $9.00 | $43.00 | $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 HumanaChoice R5826-004 (Regional PPO) | $59.00 | $5,900 | $0 | Few Generics, Few Brands |
R5826 -004 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 HumanaChoice R5826-064 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -064 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
||||||||||||
2011 HumanaChoice R5826-077 (Regional PPO) | $69.00 | $5,900 | $150 | No additional gap coverage, only the Donut Hole Discount | R5826 -077 -0 | $6.00 | $35.00 | $70.00 | $70.00 | 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 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
||||||||||||
2011 Care Improvement Plus Silver Rx (Regional PPO SNP) | $34.90 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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