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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-- This plan not offered in 2012 -- |
H5508 -002 -0 | |||||||||||
2013 ADVANTAGE Preferred (PPO) | $0.00 | $4,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H5508 -005 -0 | |||||||||||
2013 ADVANTAGE Select (PPO) | $0.00 | $4,100 | $0 | Many Generics | $8.00 | $8.00 | $45.00 | $45.00 | 3,068 2013 Formulary | |||
2012 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | R5826 -066 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | 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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2012 IU Health Plans Medicare Select (HMO) | $0.00 | $4,500 | No Rx Coverage | H7220 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 IU Health Plans Medicare Select (HMO) | $0.00 | $4,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Blue Medicare Access Value (Regional PPO) | $0.00 | $4,200 | $60 | No additional gap coverage, only the Donut Hole Discount | R5941 -009 -0 | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | ||
2013 Blue Medicare Access Value (Regional PPO) | $34.00 | $6,500 | $80 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $45.00 | $45.00 | 4,173 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H5508 -006 -0 | |||||||||||
2013 ADVANTAGE Choice (PPO) | $39.00 | $4,000 | $0 | Many Generics | $8.00 | $8.00 | $45.00 | $45.00 | 3,068 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 -- |
H6169 -013 -0 | |||||||||||
-- | ||||||||||||
2013 Today's Options Premier 600 (PFFS) | $50.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 IU Health Plans Medicare Select Plus (HMO) | $63.90 | $5,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H7220 -003 -0 | $5.50 | $35.00 | $85.00 | $85.00 | 3,814 2012 Formulary | ||
2013 IU Health Plans Medicare Select Plus (HMO) | $54.00 | $4,500 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $40.00 | $85.00 | $85.00 | 3,884 2013 Formulary | |||
2012 HumanaChoice R5826-008 (Regional PPO) | $71.00 | $6,700 | $200 | No additional gap coverage, only the Donut Hole Discount | R5826 -008 -0 | $7.00 | $35.00 | $60.00 | $60.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-008 (Regional PPO) | $66.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 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 |
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-- This plan not offered in 2012 -- |
H6169 -051 -0 | |||||||||||
-- | ||||||||||||
2013 Today's Options Premier 300 (PFFS) | $80.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H5508 -001 -0 | |||||||||||
2013 ADVANTAGE Enhanced (PPO) | $84.00 | $4,000 | $0 | Many Generics | $8.00 | $8.00 | $45.00 | $45.00 | 3,068 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H6169 -033 -0 | |||||||||||
-- | ||||||||||||
2013 Today's Options Premier Plus 650D (PFFS) | $92.00 | n/a | $85 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 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 IU Health Plans Medicare Choice (HMO-POS) | $122.70 | $4,500 | $0 | Many Generics | H7220 -004 -0 | $5.00 | $35.00 | $85.00 | $85.00 | 3,814 2012 Formulary | ||
2013 IU Health Plans Medicare Choice (HMO-POS) | $98.00 | $3,950 | $0 | Many Generics | $7.00 | $40.00 | $85.00 | $85.00 | 3,884 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H6169 -024 -0 | |||||||||||
-- | ||||||||||||
2013 Today's Options Premier Plus 350A (PFFS) | $152.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | |||
2012 Humana Gold Choice H8145-012 (PFFS) | $169.00 | $6,700 | $0 | Few Generics, Few Brands | H8145 -012 -0 | $7.00 | $40.00 | $82.00 | $82.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-012 (PFFS) | $172.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $13.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
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