2012 / 2013 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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2012 AARP MedicareComplete Plus Plan 1 (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -025 -0 | $4.00 | $7.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Plan 3 (HMO) | $0.00 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $44.00 | $44.00 | 3,825 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H0084 -032 -0 | |||||||||||
2013 Care Improvement Plus Copper RX (PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H0084 -011 -0 | |||||||||||
2013 Care Improvement Plus Gold Rx (PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 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 2012 -- |
H0084 -013 -0 | |||||||||||
2013 Care Improvement Plus Medicare Advantage (PPO) | $0.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | |||
2012 HumanaChoice H5868-004 (PPO) | $0.00 | $4,000 | No Rx Coverage | H5868 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice H5868-004 (PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice H5868-001 (PPO) | $21.00 | $4,000 | $0 | Few Generics, Few Brands |
H5868 -001 -0 | $7.00 | $42.00 | $90.00 | $90.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H5868-001 (PPO) | $30.00 | $4,000 | $0 | Few Generics, Few Brands | $7.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 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 2012 -- |
H0084 -031 -0 | |||||||||||
2013 Care Improvement Plus Chrome RX (PPO SNP) | $34.60 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H0084 -012 -0 | |||||||||||
2013 Care Improvement Plus Dual Advantage (PPO SNP) | $34.60 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H0084 -010 -0 | |||||||||||
2013 Care Improvement Plus Silver Rx (PPO SNP) | $34.60 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 2013 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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2012 AARP MedicareComplete Plan 2 (HMO) | $85.00 | $3,500 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -015 -0 | $3.00 | $6.00 | $38.00 | $38.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Plan 1 (HMO) | $85.00 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $38.00 | $38.00 | 3,825 2013 Formulary | |||
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