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 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 | |||
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. | ||||||||
-- This plan not offered in 2011 -- |
H5006 -018 -14 | |||||||||||
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2012 WindsorSterling Silver Access Plan (PFFS) | $30.00 | $4,000 | 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 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 | |||
-- This plan not offered in 2011 -- |
H5006 -017 -14 | |||||||||||
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2012 WindsorSterling Gold Access Plan (PFFS) | $55.00 | $4,000 | $50 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $34.00 | $34.00 | 2,536 2012 Formulary | |||
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 | ||
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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 | |||
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 800 (PFFS) | $90.00 | $6,700 | No Rx Coverage | H5421 -057 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Today's Options Premier 400 (PFFS) | $90.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Today's Options Premier 850F powered by CCRx (PFFS) | $100.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | H5421 -075 -0 | $4.00 | $40.00 | $80.00 | $80.00 | n/a | ||
2012 Today's Options Premier Plus 450C (PFFS) | $102.00 | $6,700 | $35 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
-- This plan not offered in 2011 -- |
H5421 -211 -0 | |||||||||||
2012 Today's Options Premier 200 (PFFS) | $125.00 | $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 Humana Gold Choice H2944-128 (PFFS) | $135.00 | $6,700 | $0 | Few Generics, Few Brands |
H2944 -128 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
2012 Humana Gold Choice H2944-128 (PFFS) | $129.00 | $6,700 | $0 | Few Generics, Few Brands | $7.00 | $40.00 | $84.00 | $84.00 | 3,798 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H5421 -215 -0 | |||||||||||
2012 Today's Options Premier Plus 250A (PFFS) | $159.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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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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 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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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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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 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 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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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 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 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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