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 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -068 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Windsor Medicare Extra Emerald Plan (HMO) | $0.00 | $6,700 | $0 | Some Generics | H5698 -061 -0 | $7.00 | $12.00 | $42.00 | $42.00 | 2,536 2012 Formulary | ||
2013 Windsor Medicare Extra Emerald Plan (HMO) | $0.00 | $6,700 | $0 | Some Generics | $3.00 | $10.00 | $44.00 | $44.00 | 2,715 2013 Formulary | |||
2012 Windsor Medicare Extra Silver Plan (HMO) | $0.00 | $3,400 | No Rx Coverage | H5698 -035 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Windsor Medicare Extra Silver Plan (HMO) | $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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2012 Windsor Medicare Extra Comp Plus Plan (HMO SNP) | $33.40 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | H5698 -134 -0 | 15% | 15% | 2,536 2012 Formulary | ||||
2013 Windsor Medicare Extra Comp Plus Plan (HMO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 2,715 2013 Formulary | |||
2012 Windsor Medicare Extra Gold Plan (HMO) | $25.00 | $3,400 | $0 | Some Generics | H5698 -028 -0 | $3.00 | $10.00 | $40.00 | $40.00 | 2,536 2012 Formulary | ||
2013 Windsor Medicare Extra Gold Plan (HMO) | $35.00 | $3,400 | $0 | Some Generics | $3.00 | $10.00 | $43.00 | $43.00 | 2,715 2013 Formulary | |||
2012 HumanaChoice R5826-078 (Regional PPO) | $40.00 | $5,900 | $320 | No additional gap coverage, only the Donut Hole Discount | R5826 -078 -0 | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-078 (Regional PPO) | $42.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 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 |
||||||
2012 HumanaChoice R5826-011 (Regional PPO) | $67.00 | $6,700 | $0 | Few Generics, Few Brands | R5826 -011 -0 | $6.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-011 (Regional PPO) | $72.00 | $6,700 | $0 | Few Generics, Few Brands | $4.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Windsor Medicare Extra Diamond Plan (HMO) | $110.00 | $3,400 | $0 | Some Generics | H5698 -067 -0 | $5.00 | $10.00 | $39.00 | $39.00 | 2,536 2012 Formulary | ||
2013 Windsor Medicare Extra Diamond Plan (HMO) | $113.00 | $4,500 | $0 | Some Generics | $3.00 | $10.00 | $40.00 | $40.00 | 2,715 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H5698 -155 -0 | |||||||||||
2013 Windsor Medicare Extra Diabetes Plan (HMO SNP) | $128.00 | n/a | $0 | Some Generics | $4.00 | $10.00 | $40.00 | $40.00 | 2,715 2013 Formulary | |||
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