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 SecureHorizons Plan 2 (HMO) | $0.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | H0543 -148 -0 | $4.00 | $7.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete SecureHorizons Plan 2 (HMO) | $0.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $45.00 | $45.00 | 3,825 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H0562 -091 -0 | |||||||||||
2013 Health Net Ruby Select (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 4,263 2013 Formulary | |||
2012 Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) | $15.30 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H0524 -030 -0 | n/a | ||||||
2013 Senior Advantage Medicare Medi-Cal Plan North (HMO SNP) | $16.60 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $12.00 | $45.00 | $45.00 | 5,250 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 SecureHorizons Plan 1 (HMO) | $78.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | H0543 -149 -0 | $3.00 | $7.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete SecureHorizons Plan 1 (HMO) | $78.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $7.00 | $45.00 | $45.00 | 3,825 2013 Formulary | |||
2012 Kaiser Permanente Senior Advantage Sac., Sonoma (HMO) | $86.00 | $3,400 | $0 | All Generics, Few Brands |
H0524 -013 -0 | n/a | ||||||
2013 Kaiser Permanente Senior Advantage Sac., Sonoma (HMO) | $86.00 | $3,400 | $0 | All Generics, Few Brands | $5.00 | $10.00 | $45.00 | $45.00 | 5,250 2013 Formulary | |||
2012 Health Net Seniority Plus Green (HMO) | $89.00 | $3,400 | No Rx Coverage | H0562 -045 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Health Net Seniority Plus Green (HMO) | $99.00 | $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 2012 -- |
H8552 -009 -0 | |||||||||||
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2013 Anthem Medicare Preferred Standard (PPO) | $105.00 | $4,400 | $95 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $9.00 | $40.00 | $40.00 | 2,838 2013 Formulary | |||
2012 Health Net Healthy Heart (HMO) | $135.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H0562 -053 -0 | n/a | ||||||
2013 Health Net Healthy Heart (HMO) | $135.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $45.00 | $45.00 | 4,263 2013 Formulary | |||
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