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 Plus (HMO-POS) | $0.00 | $2,970 | $0 | No additional gap coverage, only the Donut Hole Discount | H2654 -010 -0 | $6.00 | $42.00 | $79.00 | $79.00 | n/a | ||
2012 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $3,975 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $44.00 | $44.00 | 3,614 2012 Formulary | |||
2011 Anthem Medicare Preferred Core (PPO) | $0.00 | $4,500 | $0 | Many Generics | H1517 -004 -0 | 0% | $43.00 | $85.00 | $85.00 | n/a | ||
2012 Anthem Medicare Preferred Core (PPO) | $0.00 | $4,500 | $60 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | |||
2011 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,159 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 Humana Gold Choice H8145-120 (PFFS) | $0.00 | $5,000 | No Rx Coverage | H8145 -120 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-120 (PFFS) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Humana Gold Plus H2649-020 (HMO) | $0.00 | $2,900 | $0 | Some Generics, Few Brands |
H2649 -020 -0 | $5.00 | $40.00 | $80.00 | $80.00 | n/a | ||
2012 Humana Gold Plus H2649-020 (HMO) | $0.00 | $2,900 | $0 | Some Generics, Few Brands | $5.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
2011 HumanaChoice R5826-067 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -067 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
2012 HumanaChoice R5826-067 (Regional PPO) | $0.00 | $3,400 | 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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-- This plan not offered in 2011 -- |
H2667 -017 -0 | |||||||||||
2012 Mercy MedicareADVANTAGE (HMO-POS) | $0.00 | $2,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $35.00 | $75.00 | $75.00 | 3,171 2012 Formulary | |||
2011 Mercy MedicareADVANTAGE (no drug) (HMO) | $0.00 | $3,000 | No Rx Coverage | H2667 -012 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2012 Mercy MedicareADVANTAGE (no drug) (HMO) | $0.00 | $3,100 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2011 Ozark Health Plan - Plus (HMO) | $0.00 | $4,950 | $0 | Some Generics | H5416 -018 -0 | $5.00 | $15.00 | $45.00 | $45.00 | n/a | ||
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2012 Ozark Health Plan - Plus (HMO) | $0.00 | $5,950 | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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 Mercy MedicareADVANTAGE (HMO) | $13.30 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2667 -001 -0 | $7.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 Mercy MedicareADVANTAGE (HMO) | $12.70 | $3,100 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $40.00 | $75.00 | $75.00 | 3,242 2012 Formulary | |||
2011 ADVANTRA FREEDOM (PPO) | $19.90 | $5,500 | $0 | No additional gap coverage, only the Donut Hole Discount | H5509 -015 -0 | $7.00 | $35.00 | $60.00 | $60.00 | n/a | ||
2012 Advantra Freedom (PPO) | $19.80 | $5,500 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $35.00 | $70.00 | $70.00 | 3,171 2012 Formulary | |||
2011 Mercy MedicareAdvantage Silver (PPO) | $16.30 | $4,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H2611 -018 -0 | $7.00 | $35.00 | $70.00 | $70.00 | n/a | ||
2012 Mercy MedicareADVANTAGE (PPO) | $22.80 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $40.00 | $75.00 | $75.00 | 3,242 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 Ozark Health Plan - Dual Plus (HMO SNP) | $34.90 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | H5416 -019 -0 | n/a | ||||||
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2012 Ozark Health Plan - Dual Plus (HMO SNP) | $31.70 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2011 Care Improvement Plus Silver Rx (Regional PPO SNP) | $33.40 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Silver Rx (Regional PPO SNP) | $31.80 | n/a | $150 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | |||
2011 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $34.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -011 -0 | $10.00 | $42.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $31.90 | n/a | $240 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 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 Humana Gold Choice H8145-125 (PFFS) | $27.00 | $5,000 | $0 | Few Generics, Few Brands |
H8145 -125 -0 | $7.00 | $40.00 | $80.00 | $80.00 | n/a | ||
-- | -- | |||||||||||
2012 Humana Gold Choice H8145-125 (PFFS) | $33.00 | $5,000 | $0 | Few Generics, Few Brands | $7.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | |||
-- This plan not offered in 2011 -- |
H1716 -020 -0 | |||||||||||
2012 HumanaChoice H1716-020 (PPO) | $39.00 | $5,000 | $320 | Few Generics, Few Brands | $1.00 | $5.00 | 20% | 20% | 3,100 2012 Formulary | |||
2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $52.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -012 -0 | $9.00 | $42.00 | $95.00 | $95.00 | n/a | ||
2012 Care Improvement Plus Medicare Advantage (Regional PPO) | $60.00 | $6,700 | $215 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 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 HumanaChoice H1716-004 (PPO) | $59.00 | $3,400 | $0 | Few Generics, Few Brands |
H1716 -004 -0 | $8.00 | $41.00 | $83.00 | $83.00 | n/a | ||
2012 HumanaChoice H1716-004 (PPO) | $63.00 | $3,400 | $0 | Few Generics, Few Brands | $8.00 | $43.00 | $83.00 | $83.00 | 3,798 2012 Formulary | |||
2011 HumanaChoice R5826-010 (Regional PPO) | $69.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -010 -0 | n/a | ||||||
-- | ||||||||||||
2012 HumanaChoice R5826-010 (Regional PPO) | $105.00 | $6,700 | $320 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | |||
2011 Care Improvement Plus Medicare Advantage (Regional PPO) | $52.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -012 -0 | $9.00 | $42.00 | $95.00 | $95.00 | 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 HumanaChoice R5826-010 (Regional PPO) | $69.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | R5826 -010 -0 | n/a | ||||||
-- This plan not offered in 2012 -- |
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2011 HumanaChoice R5826-067 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -067 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2012 -- |
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2011 Anthem Medicare Preferred Select (PPO) | $57.00 | $3,800 | $0 | Many Generics | H1517 -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 |
||||||
2011 Mercy MedicareADVANTAGE Gold (PPO) | $150.30 | $6,700 | $0 | Many Generics | H2611 -002 -0 | $7.00 | $35.00 | $70.00 | $70.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $34.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -011 -0 | $10.00 | $42.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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2011 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 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 Care Improvement Plus Silver Rx (Regional PPO SNP) | $33.40 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R3444 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | n/a | ||
-- This plan not offered in 2012 -- |
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