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 Humana Gold Choice H8145-121 (PFFS) | $39.00 | $5,000 | No Rx Coverage | H8145 -121 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 Humana Gold Choice H8145-121 (PFFS) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2012 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice R5826-009 (Regional PPO) | $61.00 | $5,000 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | n/a | ||||||
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2012 HumanaChoice R5826-009 (Regional PPO) | $67.00 | $5,000 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 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 Medical Associates SmartPlan (Cost) | $96.00 | $-1 | No Rx Coverage | H5256 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Medical Associates SmartPlan (Cost) | $97.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Humana Gold Choice H8145-110 (PFFS) | $106.00 | $6,700 | $0 | Few Generics, Few Brands |
H8145 -110 -0 | $7.00 | $42.00 | $80.00 | $80.00 | n/a | ||
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2012 Humana Gold Choice H8145-110 (PFFS) | $109.00 | $6,700 | $0 | Few Generics, Few Brands | $7.00 | $42.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
2011 Medical Associates Community Plan (Cost) | $120.00 | $-1 | No Rx Coverage | H5256 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Medical Associates Community Plan (Cost) | $125.00 | n/a | 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 Medical Associates Freedom Plan (Cost) | $120.00 | $-1 | No Rx Coverage | H5256 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Medical Associates Freedom Plan (Cost) | $125.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 HumanaChoice R5826-009 (Regional PPO) | $61.00 | $5,000 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
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2011 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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