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 FHCP Medvantage (HMO-POS) | $0.00 | $6,700 | No Rx Coverage | H1035 -007 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 FHCP Medvantage (HMO-POS) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 FHCP Medvantage Rx (HMO) | $0.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | H1035 -006 -0 | 20% | 20% | 25% | 25% | 1,864 2012 Formulary | ||
2013 FHCP Medvantage Rx (HMO) | $0.00 | $6,700 | $160 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $40.00 | $40.00 | 1,991 2013 Formulary | |||
2012 Humana Gold Plus H1036-044 (HMO) | $0.00 | $3,400 | $0 | Some Generics, Few Brands |
H1036 -044 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,384 2012 Formulary | ||
2013 Humana Gold Plus H1036-044 (HMO) | $0.00 | $3,400 | $0 | Some Generics, Few Brands | $0.00 | $0.00 | $40.00 | $40.00 | 5,233 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 Humana Gold Plus H1036-056 (HMO) | $0.00 | $4,000 | No Rx Coverage | H1036 -056 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Humana Gold Plus H1036-056 (HMO) | $0.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H1036 -157 -0 | |||||||||||
2013 Humana Gold Plus H1036-157 (HMO) | $0.00 | $6,700 | $0 | Few Generics, Few Brands | $3.00 | $9.00 | $40.00 | $40.00 | 3,906 2013 Formulary | |||
2012 Humana Gold Plus SNP-DB H1036-156 (HMO SNP) | $0.00 | n/a | $0 | Some Generics, Few Brands |
H1036 -156 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,937 2012 Formulary | ||
2013 Humana Gold Plus SNP-DB H1036-156 (HMO SNP) | $0.00 | n/a | $0 | Some Generics, Few Brands | $0.00 | $0.00 | $40.00 | $40.00 | 5,233 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 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 Humana Gold Plus SNP-DE H1036-154 (HMO SNP) | $20.00 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | H1036 -154 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 4,937 2012 Formulary | ||
2013 Humana Gold Plus SNP-DE H1036-154 (HMO SNP) | $17.60 | n/a | $325 | n/a | $0.00 | $0.00 | $45.00 | $45.00 | 4,380 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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-- 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 | |||
2012 FHCP Medvantage Rx Plus (HMO-POS) | $45.50 | $4,500 | $0 | Many Generics | H1035 -002 -0 | $2.00 | $7.00 | 25% | 25% | 1,864 2012 Formulary | ||
2013 FHCP Medvantage Rx Plus (HMO-POS) | $48.00 | $2,900 | $0 | Many Generics | $0.00 | $4.00 | 25% | 25% | 1,991 2013 Formulary | |||
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 | |||
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 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 | |||
2012 HumanaChoice H5415-066 (PPO) | $129.00 | $3,400 | $0 | Few Generics, Few Brands |
H5415 -066 -0 | $7.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H5415-066 (PPO) | $132.00 | $3,400 | $0 | Few Generics, Few Brands | $7.00 | $40.00 | $80.00 | $80.00 | 3,906 2013 Formulary | |||
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