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 AAA0 Vantage ZERO (HMO-POS) | $0.00 | $5,200 | $0 | No additional gap coverage, only the Donut Hole Discount | H5576 -007 -0 | $5.00 | $40.00 | $80.00 | $80.00 | 3,769 2012 Formulary | ||
2013 AAA0 Vantage ZERO (HMO-POS) | $0.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H1951 -042 -0 | |||||||||||
2013 Humana Gold Plus H1951-042 (HMO) | $0.00 | $4,950 | $0 | Few Generics, Few Brands | $6.00 | $8.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -068 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | 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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-- This plan not offered in 2012 -- |
H1951 -041 -0 | |||||||||||
2013 Humana Gold Plus SNP-DE H1951-041 (HMO SNP) | $33.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 AAA4 Vantage TRADITIONAL PLUS (HMO) | $35.00 | $6,700 | $320 | No additional gap coverage, only the Donut Hole Discount | H5576 -008 -0 | 25% | 25% | 25% | 25% | 3,769 2012 Formulary | ||
2013 AAA4 Vantage TRADITIONAL PLUS (HMO) | $37.30 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,768 2013 Formulary | |||
2012 HumanaChoice R5826-078 (Regional PPO) | $40.00 | $5,900 | $320 | No additional gap coverage, only the Donut Hole Discount | R5826 -078 -0 | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-078 (Regional PPO) | $42.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 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 AAA1 Vantage VALUE (HMO-POS) | $49.00 | $3,800 | $0 | No additional gap coverage, only the Donut Hole Discount | H5576 -009 -0 | $0.00 | $35.00 | $75.00 | $75.00 | 3,769 2012 Formulary | ||
2013 AAA1 Vantage VALUE (HMO-POS) | $51.00 | $5,900 | $325 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | |||
2012 HumanaChoice R5826-011 (Regional PPO) | $67.00 | $6,700 | $0 | Few Generics, Few Brands |
R5826 -011 -0 | $6.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-011 (Regional PPO) | $72.00 | $6,700 | $0 | Few Generics, Few Brands | $4.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 AAA3 Vantage PREMIUM (HMO-POS) | $99.00 | $3,800 | $0 | Many Generics | H5576 -006 -0 | $0.00 | $35.00 | $75.00 | $75.00 | 3,769 2012 Formulary | ||
2013 AAA3 Vantage PREMIUM (HMO-POS) | $132.00 | $5,200 | $325 | Many Generics | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | |||
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