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 Essential (HMO) | $0.00 | $3,750 | No Rx Coverage | H4102 -025 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 AARP MedicareComplete Essential (HMO) | $0.00 | $4,250 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $4,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H4102 -001 -0 | $6.00 | $45.00 | $85.00 | $85.00 | n/a | ||
2012 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $4,750 | $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 -- |
H4152 -016 -0 | |||||||||||
2012 BlueCHiP for Medicare Value (HMO-POS) | $0.00 | $4,800 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $45.00 | $45.00 | 3,055 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 AARP MedicareComplete Choice (Regional PPO) | $0.00 | $4,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R7444 -001 -0 | $6.00 | $45.00 | $85.00 | $85.00 | n/a | ||
2012 AARP MedicareComplete Choice (Regional PPO) | $20.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $8.00 | $45.00 | $45.00 | 3,614 2012 Formulary | |||
2011 Evercare Plan IP (PPO SNP) | $33.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H2228 -002 -0 | n/a | ||||||
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2012 UnitedHealthcare Nursing Home Plan (PPO SNP) | $32.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,614 2012 Formulary | |||
2011 BlueCHiP for Medicare Core (HMO) | $35.00 | $3,350 | No Rx Coverage | H4152 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 BlueCHiP for Medicare Core (HMO) | $35.00 | $3,350 | 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 BlueCHiP for Medicare Standard with Drugs (HMO) | $45.00 | $3,350 | $0 | No additional gap coverage, only the Donut Hole Discount | H4152 -013 -0 | $5.00 | $10.00 | $38.00 | $38.00 | n/a | ||
2012 BlueCHiP for Medicare Standard with Drugs (HMO) | $46.00 | $3,350 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $12.00 | $40.00 | $40.00 | 3,055 2012 Formulary | |||
2011 BlueCHiP for Medicare Plus (HMO) | $149.00 | $2,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H4152 -005 -0 | $4.00 | $8.00 | $30.00 | $30.00 | n/a | ||
2012 BlueCHiP for Medicare Plus (HMO) | $157.00 | $2,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $35.00 | $35.00 | 3,055 2012 Formulary | |||
2011 BlueCHiP for Medicare Preferred (HMO-POS) | $269.00 | $1,750 | $0 | Many Generics | H4152 -007 -0 | $4.00 | $8.00 | $30.00 | $30.00 | n/a | ||
2012 BlueCHiP for Medicare Preferred (HMO-POS) | $279.00 | $1,750 | $0 | Many Generics | $4.00 | $10.00 | $35.00 | $35.00 | 3,055 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 AARP MedicareComplete Choice (Regional PPO) | $0.00 | $4,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R7444 -001 -0 | $6.00 | $45.00 | $85.00 | $85.00 | n/a | ||
-- This plan not offered in 2012 -- |
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