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 Plan 2 (HMO) | $0.00 | $3,800 | $0 | No additional gap coverage, only the Donut Hole Discount | H3659 -031 -0 | $5.00 | $42.00 | $79.00 | $79.00 | n/a | ||
2012 AARP MedicareComplete Plan 2 (HMO) | $0.00 | $4,300 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $45.00 | $45.00 | 3,614 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H1849 -015 -0 | |||||||||||
2012 Anthem Senior Advantage Value (HMO) | $0.00 | $3,400 | $60 | Many Generics | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
2011 Blue Medicare Access Value (Regional PPO) | $0.00 | $3,900 | $0 | Many Generics | R5941 -009 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 Blue Medicare Access Value (Regional PPO) | $0.00 | $4,200 | $60 | No additional gap coverage, only the Donut Hole Discount | $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 |
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2011 Humana Gold Plus H8953-001 (HMO) | $0.00 | $3,750 | $0 | Some Generics, Few Brands |
H8953 -001 -0 | $6.00 | $39.00 | $80.00 | $80.00 | n/a | ||
2012 Humana Gold Plus H8953-001 (HMO) | $0.00 | $3,750 | $0 | Many Generics, Few Brands | $6.00 | $43.00 | $86.00 | $86.00 | 3,798 2012 Formulary | |||
2011 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -066 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Anthem Medicare Preferred Standard (PPO) | $24.00 | $4,500 | $0 | Many Generics | H5530 -001 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 Anthem Medicare Preferred Standard (PPO) | $28.00 | $4,500 | $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 |
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-- This plan not offered in 2011 -- |
H1849 -016 -0 | |||||||||||
2012 Anthem Senior Advantage Complete (HMO) | $35.00 | $3,000 | $60 | Many Generics | $5.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
2011 HumanaChoice H3619-001 (PPO) | $42.00 | $4,700 | $0 | Few Generics, Few Brands |
H3619 -001 -0 | $8.00 | $41.00 | $82.00 | $82.00 | n/a | ||
2012 HumanaChoice H3619-001 (PPO) | $42.00 | $4,700 | $0 | Few Generics, Few Brands | $7.00 | $43.00 | $86.00 | $86.00 | 3,798 2012 Formulary | |||
2011 Blue Medicare Access Standard (Regional PPO) | $39.00 | $3,300 | $0 | Many Generics | R5941 -003 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 Blue Medicare Access Standard (Regional PPO) | $43.00 | $3,400 | $60 | No additional gap coverage, only the Donut Hole Discount | $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 |
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-- This plan not offered in 2011 -- |
H5162 -018 -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 | |||
2011 Anthem Medicare Preferred Select (PPO) | $59.00 | $3,400 | $0 | Many Generics | H5530 -004 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
2012 Anthem Medicare Preferred Select (PPO) | $59.00 | $3,400 | $60 | Many Generics | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
2011 Humana Gold Choice H8145-021 (PFFS) | $61.00 | $6,700 | $0 | Few Generics, Few Brands |
H8145 -021 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-021 (PFFS) | $69.00 | $6,700 | $0 | Few Generics, Few Brands | $7.00 | $42.00 | $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 |
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2011 HumanaChoice R5826-008 (Regional PPO) | $71.00 | $5,500 | $0 | Few Generics, Few Brands |
R5826 -008 -0 | $6.00 | $39.00 | $80.00 | $80.00 | n/a | ||
-- | ||||||||||||
2012 HumanaChoice R5826-008 (Regional PPO) | $71.00 | $6,700 | $200 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $35.00 | $60.00 | $60.00 | 3,798 2012 Formulary | |||
2011 Anthem Senior Advantage Basic (HMO) | $0.00 | $3,400 | $0 | Many Generics | H1849 -005 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Humana Gold Choice H8145-025 (PFFS) | $19.00 | $6,700 | No Rx Coverage | H8145 -025 -0 | 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 HumanaChoice R5826-082 (Regional PPO) | $61.00 | $7,500 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -082 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
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2011 Sterling Connect 1 (PFFS) | $49.00 | $3,000 | No Rx Coverage | H3410 -002 -4 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Sterling Connect 2 (PFFS) | $70.70 | $4,000 | $200 | No additional gap coverage, only the Donut Hole Discount | H3410 -003 -4 | $4.00 | $18.00 | $40.00 | $40.00 | 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 Sterling Connect Basic (PFFS) | $29.00 | $5,000 | No Rx Coverage | H3410 -001 -4 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Blue Medicare Access Standard (Regional PPO) | $39.00 | $3,300 | $0 | Many Generics | R5941 -003 -0 | $7.00 | $43.00 | $85.00 | $85.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Blue Medicare Access Value (Regional PPO) | $0.00 | $3,900 | $0 | Many Generics | R5941 -009 -0 | $7.00 | $43.00 | $85.00 | $85.00 | 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 R5826-008 (Regional PPO) | $71.00 | $5,500 | $0 | Few Generics, Few Brands |
R5826 -008 -0 | $6.00 | $39.00 | $80.00 | $80.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -066 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 HumanaChoice R5826-082 (Regional PPO) | $61.00 | $7,500 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -082 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
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