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 Choice Essential (Regional PPO) | $0.00 | $4,500 | No Rx Coverage | R5287 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 AARP MedicareComplete Choice Essential (Regional PPO) | $0.00 | $3,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 AARP MedicareComplete Choice Plan 2 (Regional PPO) | $0.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | R5287 -001 -0 | $3.00 | $6.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Choice Plan 2 (Regional PPO) | $0.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | |||
2012 BlueMedicare Regional PPO (Regional PPO) | $0.00 | $4,750 | $0 | No additional gap coverage, only the Donut Hole Discount | R3332 -001 -0 | $6.00 | $45.00 | $85.00 | $85.00 | 3,656 2012 Formulary | ||
2013 BlueMedicare Regional PPO (Regional PPO) | $0.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $10.00 | $45.00 | $45.00 | 3,729 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 Humana Reader's Digest Healthy Living Plan (Regional PPO) | $0.00 | $4,950 | $0 | Few Generics, Few Brands |
R5826 -074 -0 | $7.00 | $41.00 | $81.00 | $81.00 | 3,798 2012 Formulary | ||
2013 Humana Reader's Digest Healthy Living Plan (Regional PPO) | $0.00 | $4,950 | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 HumanaChoice R5826-018 (Regional PPO) | $0.00 | $4,000 | No Rx Coverage | R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-018 (Regional PPO) | $0.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Optimum Gold Rewards Plan (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5594 -018 -0 | $0.00 | $39.00 | $69.00 | $69.00 | 2,608 2012 Formulary | ||
2013 Optimum Gold Rewards Plan (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $39.00 | $69.00 | $69.00 | 2,768 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 |
||||||
2012 Optimum Platinum Plan (HMO-POS) | $0.00 | $3,400 | $0 | Many Generics | H5594 -019 -0 | $0.00 | $39.00 | $65.00 | $65.00 | 2,608 2012 Formulary | ||
2013 Optimum Platinum Plan (HMO-POS) | $0.00 | $3,400 | $0 | Many Generics | $0.00 | $20.00 | $65.00 | $65.00 | 2,768 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H1032 -037 -0 | |||||||||||
2013 WellCare Advance (HMO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H1032 -133 -0 | |||||||||||
2013 WellCare Essential (HMO) | $0.00 | $3,400 | $0 | All Generics | $0.00 | $39.00 | $79.00 | $79.00 | 2,835 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 |
||||||
-- This plan not offered in 2012 -- |
H1032 -124 -0 | |||||||||||
2013 WellCare Liberty (HMO SNP) | $8.70 | n/a | $325 | n/a | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H1032 -175 -0 | |||||||||||
2013 WellCare Access (HMO SNP) | $12.10 | n/a | $325 | n/a | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H1032 -101 -0 | |||||||||||
2013 WellCare Select (HMO-POS SNP) | $12.50 | n/a | $325 | n/a | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 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 |
||||||
-- This plan not offered in 2012 -- |
H5594 -017 -0 | |||||||||||
2013 Optimum Emerald Full (HMO SNP) | $24.80 | n/a | $325 | n/a | 25% | 2,764 2013 Formulary | ||||||
-- This plan not offered in 2012 -- |
H5594 -016 -0 | |||||||||||
2013 Optimum Emerald Partial (HMO SNP) | $24.80 | n/a | $325 | n/a | 25% | 2,764 2013 Formulary | ||||||
-- This plan not offered in 2012 -- |
R5287 -003 -0 | |||||||||||
2013 UnitedHealthcare Dual Complete RP (Regional PPO SNP) | $24.80 | n/a | $325 | n/a | 25% | 25% | 25% | 25% | 3,825 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 |
||||||
2012 HumanaChoice R5826-005 (Regional PPO) | $80.00 | $4,750 | $0 | Few Generics, Few Brands |
R5826 -005 -0 | $2.00 | $8.00 | $40.00 | $40.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-005 (Regional PPO) | $85.00 | $4,750 | $0 | Few Generics, Few Brands | $3.00 | $8.00 | $40.00 | $40.00 | 3,906 2013 Formulary | |||
2012 Humana Gold Choice H8145-061 (PFFS) | $99.00 | $6,700 | $0 | Few Generics, Few Brands |
H8145 -061 -0 | $8.00 | $42.00 | $81.00 | $81.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-061 (PFFS) | $102.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
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