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 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 | |||
2012 Kaiser Permanente Senior Advantage Solano (HMO) | $75.00 | $3,400 | $0 | All Generics, Few Brands |
H0524 -008 -0 | n/a | ||||||
2013 Kaiser Permanente Senior Advantage Solano (HMO) | $75.00 | $3,400 | $0 | All Generics, Few Brands | $5.00 | $10.00 | $45.00 | $45.00 | 5,250 2013 Formulary | |||
2012 PartnershipAdvantage (HMO SNP) | $78.40 | n/a | $0 | Many Generics | H5782 -001 -0 | $0.00 | $45.00 | 3,165 2012 Formulary | ||||
2013 PartnershipAdvantage (HMO SNP) | $85.60 | n/a | $0 | Many Generics | $0.00 | $45.00 | 3,325 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 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. | ||||||||
-- This plan not offered in 2012 -- |
H0562 -017 -0 | |||||||||||
2013 Health Net Seniority Plus Ruby (HMO) | $182.00 | $5,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $45.00 | $45.00 | 4,263 2013 Formulary | |||
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