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 H6609-024 (PPO) | $0.00 | $4,000 | No Rx Coverage | H6609 -024 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 HumanaChoice H6609-024 (PPO) | $0.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice H6609-017 (PPO) | $49.00 | $4,000 | $0 | Few Generics, Few Brands |
H6609 -017 -0 | $6.00 | $35.00 | $75.00 | $75.00 | n/a | ||
2012 HumanaChoice H6609-017 (PPO) | $51.00 | $4,000 | $0 | Few Generics, Few Brands | $6.00 | $35.00 | $75.00 | $75.00 | 3,798 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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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 -- |
H2450 -022 -0 | |||||||||||
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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 | |||
-- This plan not offered in 2011 -- |
H2450 -023 -0 | |||||||||||
-- | ||||||||||||
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 | |||
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 -- |
H2450 -016 -0 | |||||||||||
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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 | |||
-- This plan not offered in 2011 -- |
H2450 -001 -0 | |||||||||||
-- | ||||||||||||
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 | |||
-- This plan not offered in 2011 -- |
H2450 -017 -0 | |||||||||||
-- | ||||||||||||
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 | |||
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 -- |
H2450 -028 -0 | |||||||||||
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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 | |||
-- This plan not offered in 2011 -- |
H2450 -002 -0 | |||||||||||
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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 | |||
-- This plan not offered in 2011 -- |
H2450 -005 -0 | |||||||||||
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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 | |||
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 -- |
H2450 -006 -0 | |||||||||||
-- | ||||||||||||
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 | |||
-- 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 | |||
-- 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 | |||
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 H6609-018 (PPO) | $29.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H6609 -018 -0 | $4.00 | $34.00 | $67.00 | $67.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Sol. Enhanced w/Enhanced Rx - ND/SD (Cost) | $223.30 | $3,000 | $0 | Many Generics | H2450 -015 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Sol. Value Plus w/Thrift Rx - ND/SD (Cost) | $89.50 | $3,350 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -026 -0 | $10.00 | $34.00 | 25% | 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 Medica Prime Solution Basic w/Enhanced Rx - ND/SD (Cost) | $175.30 | $3,000 | $0 | Many Generics | H2450 -013 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Solution Basic w/Standard Rx - ND/SD (Cost) | $122.30 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -012 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Solution Basic with Thrift Rx - ND/SD (Cost) | $113.50 | $3,000 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -020 -0 | $10.00 | $34.00 | 25% | 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 Medica Prime Solution Enhanced w/Thrift Rx - ND/SD (Cost) | $161.50 | $3,000 | $180 | No additional gap coverage, only the Donut Hole Discount | H2450 -021 -0 | $10.00 | $34.00 | 25% | n/a | |||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Solution Enhanced with Std Rx - ND/SD (Cost) | $170.30 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -014 -0 | $10.00 | $34.00 | $74.00 | $74.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Medica Prime Solution Value Plus w/Std Rx - ND/SD (Cost) | $98.30 | $3,350 | $0 | No additional gap coverage, only the Donut Hole Discount | H2450 -027 -0 | $10.00 | $34.00 | $74.00 | $74.00 | 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 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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