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 HumanaChoice H6609-006 (PPO) | $0.00 | $6,000 | No Rx Coverage | H6609 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 HumanaChoice H6609-006 (PPO) | $0.00 | $6,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice H6609-022 (PPO) | $29.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H6609 -022 -0 | $5.00 | $38.00 | $74.00 | $74.00 | n/a | ||
2012 HumanaChoice H6609-022 (PPO) | $29.00 | $4,000 | $320 | Few Generics, Few Brands | $1.00 | $5.00 | 20% | 20% | 3,100 2012 Formulary | |||
2011 Platinum Blue Core Plan (Cost) | $35.00 | $3,000 | No Rx Coverage | H2461 -005 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Platinum Blue Core Plan (Cost) | $35.00 | $5,000 | 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 Medica DUAL Solution (HMO SNP) | $37.50 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2458 -002 -0 | n/a | ||||||
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2012 Medica DUAL Solution (HMO SNP) | $36.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 3,165 2012 Formulary | |||||
2011 SecureBlue (HMO SNP) | $38.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2425 -001 -0 | n/a | ||||||
2012 SecureBlue (HMO SNP) | $36.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 2,602 2012 Formulary | |||||
2011 UCare's Minnesota Senior Health Options (HMO SNP) | $39.20 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2456 -002 -0 | n/a | ||||||
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2012 UCare's Minnesota Senior Health Options (HMO SNP) | $36.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 2,804 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 UCare for Seniors Value (HMO-POS) | $41.00 | $3,400 | No Rx Coverage | H2459 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 UCare for Seniors Value (HMO-POS) | $43.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HealthPartners Freedom Plan I (Cost) | $61.00 | $-1 | No Rx Coverage | H2462 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HealthPartners Freedom Basic (Cost) | $45.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice H6609-005 (PPO) | $49.00 | $4,000 | $0 | Few Generics, Few Brands |
H6609 -005 -0 | $6.00 | $36.00 | $75.00 | $75.00 | n/a | ||
2012 HumanaChoice H6609-005 (PPO) | $49.00 | $4,000 | $0 | Few Generics, Few Brands | $6.00 | $36.00 | $75.00 | $75.00 | 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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-- This plan not offered in 2011 -- |
H2462 -018 -0 | |||||||||||
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2012 HealthPartners Freedom Vital (Cost) | $53.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 UCare for Seniors Standard D (HMO-POS) | $58.00 | $3,400 | $310 | No additional gap coverage, only the Donut Hole Discount | H2459 -018 -0 | n/a | ||||||
2012 UCare for Seniors Standard D (HMO-POS) | $54.00 | $3,400 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 2,804 2012 Formulary | |||||
2011 Medica Prime Solution Value Thrift with Rx (Cost) | $61.50 | $5,000 | $185 | No additional gap coverage, only the Donut Hole Discount | H2450 -007 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Thrift with Part D Option 1 (Cost) | $55.50 | $6,700 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,886 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 -- |
H2462 -019 -0 | |||||||||||
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2012 HealthPartners Freedom Vital with Rx (Cost) | $60.20 | $3,000 | $175 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 2,632 2012 Formulary | |||
2011 Platinum Blue Choice Plan (Cost) | $79.00 | $3,000 | No Rx Coverage | H2461 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Platinum Blue Choice Plan (Cost) | $79.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 UCare for Seniors Value Plus (HMO-POS) | $79.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H2459 -013 -0 | $9.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 UCare for Seniors Value Plus (HMO-POS) | $84.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $35.00 | $70.00 | $70.00 | 4,776 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 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 | |||
-- This plan not offered in 2011 -- |
H6609 -051 -0 | |||||||||||
2012 HumanaChoice H6609-051 (PPO) | $85.00 | $3,400 | $0 | Few Generics, Few Brands | $8.00 | $45.00 | $89.00 | $89.00 | 3,798 2012 Formulary | |||
2011 Medica Prime Solution Value Plus w/Thrift Rx - MN (Cost) | $89.50 | $3,350 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -022 -0 | $10.00 | $34.00 | 25% | n/a | |||
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2012 Medica Prime Solution Value with Part D Option 1 (Cost) | $85.50 | $3,350 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,886 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 HealthPartners Freedom Plan II (Cost) | $93.00 | $3,000 | No Rx Coverage | H2462 -007 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HealthPartners Freedom Balance (Cost) | $93.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Medica Prime Solution Value Plus with Std Rx - MN (Cost) | $98.30 | $3,350 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -023 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Value with Part D Option 2 (Cost) | $102.60 | $3,350 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
2011 HealthPartners Freedom Plan II Standard Rx (Cost) | $104.60 | $3,000 | $230 | No additional gap coverage, only the Donut Hole Discount | H2462 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 HealthPartners Freedom Balance with Rx (Cost) | $102.80 | $3,000 | $125 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 2,632 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 Medica Prime Solution Basic with Thrift Rx - MN (Cost) | $113.50 | $3,000 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -016 -0 | $10.00 | $34.00 | 25% | n/a | |||
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2012 Medica Prime Solution Basic with Part D Option 1 (Cost) | $105.50 | $3,000 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,886 2012 Formulary | |||
2011 Platinum Blue Complete Plan (Cost) | $109.00 | $3,000 | No Rx Coverage | H2461 -007 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Platinum Blue Complete Plan (Cost) | $119.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Medica Prime Solution Basic with Standard Rx - MN (Cost) | $122.30 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -001 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Basic with Part D Option 2 (Cost) | $122.60 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 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 UCare for Seniors Classic (HMO-POS) | $129.00 | $3,400 | $0 | Many Generics | H2459 -002 -0 | $9.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 UCare for Seniors Classic (HMO-POS) | $137.00 | $3,400 | $0 | Many Generics | $10.00 | $35.00 | $70.00 | $70.00 | 4,776 2012 Formulary | |||
2011 HealthPartners Freedom Plan III (Cost) | $134.00 | $3,000 | No Rx Coverage | H2462 -010 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HealthPartners Freedom Ultimate (Cost) | $138.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Medica Complete Solution-Diabetes, Cardio Dis, HF (HMO SNP) | $122.90 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H7526 -004 -0 | $10.00 | $34.00 | $67.00 | $67.00 | n/a | ||
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2012 Medica Complete Solution-Diabetes, Cardio Dis, HF (HMO SNP) | $153.10 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $67.00 | $67.00 | 4,886 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 Medica Prime Solution Enhanced with Thrift Rx - MN (Cost) | $161.50 | $3,000 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -017 -0 | $10.00 | $34.00 | 25% | n/a | |||
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2012 Medica Prime Solution Enhanced w/Part D Option 1 (Cost) | $155.50 | $3,000 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,886 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H2450 -028 -0 | |||||||||||
-- | ||||||||||||
2012 Medica Prime Solution Value with Part D Option 3 (Cost) | $161.20 | $3,350 | $0 | Many Generics | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
2011 HealthPartners Freedom Plan III StandardRx (Cost) | $158.90 | $3,000 | $150 | No additional gap coverage, only the Donut Hole Discount | H2462 -011 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
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2012 HealthPartners Freedom Ultimate with Rx (Cost) | $162.90 | $3,000 | $150 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 2,632 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 Medica Prime Solution Enhanced w/Standard Rx - MN (Cost) | $170.30 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -002 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Enhanced w/Part D Option 2 (Cost) | $172.60 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
2011 Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) | $175.20 | $3,000 | $0 | Many Generics | H2450 -005 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Basic with Part D Option 3 (Cost) | $181.20 | $3,000 | $0 | Many Generics | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
2011 Medica Complete Solution - Chronic Lung Disorders (HMO SNP) | $147.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H7526 -003 -0 | $10.00 | $34.00 | $67.00 | $67.00 | n/a | ||
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2012 Medica Complete Solution - Chronic Lung Disorders (HMO SNP) | $185.50 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $67.00 | $67.00 | 4,886 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 Medica Prime Solution Enhanced w/Enhanced Rx- MN (Cost) | $223.30 | $3,000 | $0 | Many Generics | H2450 -006 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
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2012 Medica Prime Solution Enhanced w/Part D Option 3 (Cost) | $231.20 | $3,000 | $0 | Many Generics | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
2011 Medica Complete Solution - Dementia (HMO SNP) | $370.60 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H7526 -001 -0 | $10.00 | $34.00 | $67.00 | $67.00 | n/a | ||
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2012 Medica Complete Solution - Dementia (HMO SNP) | $257.20 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $34.00 | $67.00 | $67.00 | 4,886 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H3283 -001 -0 | |||||||||||
new | new | new | ||||||||||
2012 Medica Clear Solution with Part D Option 1 (PPO) | $262.70 | $2,500 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 4,886 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 HealthPartners Freedom Plan III EnhancedRx (Cost) | $333.80 | $3,000 | $100 | Many Generics, Some Brands |
H2462 -012 -0 | $10.00 | $40.00 | $65.00 | $65.00 | n/a | ||
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2012 HealthPartners Freedom Ultimate with Enhanced Rx (Cost) | $347.00 | $3,000 | $100 | Many Generics, Some Brands | $10.00 | $40.00 | $65.00 | $65.00 | 2,632 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H3283 -002 -0 | |||||||||||
new | new | new | ||||||||||
2012 Medica Clear Solution with Part D Option 3 (PPO) | $347.10 | $2,500 | $0 | Many Generics | $10.00 | $34.00 | $74.00 | $74.00 | 4,886 2012 Formulary | |||
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 -- |
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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 UCare Connect (HMO SNP) | $23.00 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2459 -016 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
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