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 True Blue (HMO) | $25.00 | $3,000 | No Rx Coverage | H1350 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 True Blue (HMO) | $25.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Secure Blue (PPO) | $20.00 | $3,000 | No Rx Coverage | H1302 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Secure Blue (PPO) | $40.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Regence MedAdvantage (PPO) | $48.00 | $2,500 | No Rx Coverage | H1304 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Regence MedAdvantage Basic (PPO) | $54.00 | $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 |
||||||
2011 Secure Blue (PPO) | $43.00 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H1302 -001 -0 | $6.00 | $31.00 | $41.00 | $41.00 | n/a | ||
2012 Secure Blue (PPO) | $60.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $43.00 | $93.00 | $93.00 | 4,794 2012 Formulary | |||
2011 Regence MedAdvantage + Rx Classic (PPO) | $89.00 | $3,400 | $100 | No additional gap coverage, only the Donut Hole Discount | H1304 -002 -0 | $5.00 | $35.00 | $35.00 | $35.00 | n/a | ||
2012 Regence MedAdvantage + Rx Classic (PPO) | $99.00 | $3,400 | $160 | No additional gap coverage, only the Donut Hole Discount | $7.50 | $33.00 | $45.00 | $45.00 | 4,317 2012 Formulary | |||
2011 True Blue Rx Option II (HMO) | $116.00 | $3,000 | $260 | No additional gap coverage, only the Donut Hole Discount | H1350 -010 -0 | $6.00 | $31.00 | $41.00 | $41.00 | n/a | ||
2012 True Blue Rx Option II (HMO) | $116.00 | $3,000 | $260 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $31.00 | $41.00 | $41.00 | 4,794 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 True Blue Rx Option I (HMO) | $135.00 | $3,000 | $0 | Many Generics | H1350 -001 -0 | $6.00 | $31.00 | $41.00 | $41.00 | n/a | ||
2012 True Blue Rx Option I (HMO) | $135.00 | $3,000 | $0 | Many Generics | $6.00 | $31.00 | $41.00 | $41.00 | 4,794 2012 Formulary | |||
2011 Regence MedAdvantage + Rx Enhanced (PPO) | $143.00 | $2,500 | $0 | Many Generics | H1304 -004 -0 | $5.00 | $35.00 | $35.00 | $35.00 | n/a | ||
2012 Regence MedAdvantage + Rx Enhanced (PPO) | $173.00 | $2,500 | $0 | Many Generics | $5.00 | $33.00 | $45.00 | $45.00 | 4,317 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H1350 -009 -0 | |||||||||||
2012 True Blue Special Needs Plan (HMO SNP) | $173.60 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,794 2012 Formulary | |||
|