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 Plus Plan 1 (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -025 -0 | $4.00 | $7.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Plan 3 (HMO) | $0.00 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $44.00 | $44.00 | 3,825 2013 Formulary | |||
2012 Advantra Platinum (PPO) | $0.00 | $3,300 | $0 | No additional gap coverage, only the Donut Hole Discount | H1608 -001 -0 | $5.00 | $40.00 | $80.00 | $80.00 | 3,171 2012 Formulary | ||
2013 Coventry Advantra Platinum (PPO) | $0.00 | $3,300 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $7.00 | $42.00 | $42.00 | 3,224 2013 Formulary | |||
2012 Advantra Silver (HMO) | $0.00 | $3,300 | $0 | No additional gap coverage, only the Donut Hole Discount | H1609 -001 -0 | $5.00 | $40.00 | $80.00 | $80.00 | 3,171 2012 Formulary | ||
2013 Coventry Advantra Silver (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $7.00 | $42.00 | $42.00 | 3,224 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 Plan 2 (HMO) | $85.00 | $3,500 | $0 | No additional gap coverage, only the Donut Hole Discount | H4456 -015 -0 | $3.00 | $6.00 | $38.00 | $38.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Plan 1 (HMO) | $85.00 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $38.00 | $38.00 | 3,825 2013 Formulary | |||
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