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 Humana Gold Choice H8145-120 (PFFS) | $0.00 | $6,700 | No Rx Coverage | H8145 -120 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Humana Gold Choice H8145-120 (PFFS) | $0.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice R5826-069 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -069 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-069 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Advantra Freedom (PPO) | $19.70 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5509 -010 -0 | $6.00 | $35.00 | $70.00 | $70.00 | 3,171 2012 Formulary | ||
2013 Advantra Freedom (PPO) | $19.70 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $40.00 | $80.00 | $80.00 | 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 HumanaChoice H7188-006 (PPO) | $39.00 | $5,000 | $320 | Few Generics, Few Brands |
H7188 -006 -0 | $1.00 | $5.00 | 20% | 20% | 3,100 2012 Formulary | ||
2013 HumanaChoice H7188-006 (PPO) | $48.00 | $5,500 | $325 | Few Generics | $1.00 | $3.00 | 19% | 19% | 3,251 2013 Formulary | |||
2012 HumanaChoice H7188-003 (PPO) | $66.00 | $5,000 | $0 | Few Generics, Few Brands |
H7188 -003 -0 | $6.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H7188-003 (PPO) | $71.00 | $5,000 | $0 | Few Generics, Few Brands | $6.00 | $11.00 | $43.00 | $43.00 | 3,906 2013 Formulary | |||
2012 Humana Gold Choice H8145-124 (PFFS) | $51.00 | $5,000 | $0 | Few Generics, Few Brands |
H8145 -124 -0 | $7.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-124 (PFFS) | $74.00 | n/a | $0 | Few Generics, Few Brands | $8.00 | $13.00 | $43.00 | $43.00 | 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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2012 HumanaChoice R5826-013 (Regional PPO) | $161.00 | $3,400 | $320 | No additional gap coverage, only the Donut Hole Discount | R5826 -013 -0 | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-013 (Regional PPO) | $164.00 | $3,400 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | |||
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