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 Bravo Achieve Plus (HMO-POS SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H2108 -029 -0 | $4.00 | $10.00 | $40.00 | $40.00 | 2,990 2012 Formulary | ||
2013 Bravo-HealthSpring Achieve (HMO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $40.00 | $40.00 | 3,057 2013 Formulary | |||
2012 Bravo Classic Plus (HMO-POS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H2108 -028 -0 | $4.00 | $10.00 | $40.00 | $40.00 | 2,990 2012 Formulary | ||
2013 Bravo-HealthSpring Classic (HMO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $40.00 | $40.00 | 3,056 2013 Formulary | |||
2012 Bravo Achieve (HMO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H2108 -030 -0 | $8.00 | $15.00 | $45.00 | $45.00 | 2,990 2012 Formulary | ||
2013 Bravo-HealthSpring Achieve Essential (HMO SNP) | $24.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $45.00 | $45.00 | 3,057 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 Bravo Classic (HMO) | $0.00 | $6,700 | $50 | No additional gap coverage, only the Donut Hole Discount | H2108 -022 -0 | $8.00 | $15.00 | $45.00 | $45.00 | 2,990 2012 Formulary | ||
2013 Bravo-HealthSpring Essential (HMO) | $25.00 | $6,700 | $45 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $45.00 | $45.00 | 3,056 2013 Formulary | |||
2012 Aetna Medicare Standard Plan (HMO) | $54.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5813 -003 -0 | $6.00 | $33.00 | $45.00 | $45.00 | 3,158 2012 Formulary | ||
2013 Aetna Medicare Standard Plan (HMO) | $26.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $33.00 | $45.00 | $45.00 | 3,323 2013 Formulary | |||
2012 Bravo Select (HMO SNP) | $34.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | H2108 -001 -0 | 15% | 15% | 2,990 2012 Formulary | ||||
2013 Bravo-HealthSpring Select (HMO SNP) | $32.90 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 3,025 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 UnitedHealthcare Nursing Home Plan (PPO SNP) | $31.20 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | H2111 -001 -0 | 25% | 25% | 25% | 25% | 3,614 2012 Formulary | ||
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2013 UnitedHealthcare Nursing Home Plan (PPO SNP) | $34.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | |||
2012 Aetna Medicare Premier Plan (HMO) | $129.00 | $6,700 | $0 | Many Generics | H5813 -006 -0 | $4.00 | $31.00 | $45.00 | $45.00 | 3,158 2012 Formulary | ||
2013 Aetna Medicare Premier Plan (HMO) | $99.00 | $6,700 | $0 | Some Generics | $6.00 | $33.00 | $45.00 | $45.00 | 3,323 2013 Formulary | |||
2012 Aetna Medicare Premier Plan (PPO) | $165.00 | $6,700 | $0 | Many Generics | H8684 -001 -0 | $4.00 | $33.00 | $45.00 | $45.00 | 3,158 2012 Formulary | ||
2013 Aetna Medicare Premier Plan (PPO) | $169.00 | $6,700 | $0 | Some Generics | $6.00 | $33.00 | $45.00 | $45.00 | 3,323 2013 Formulary | |||
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