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 Aetna Medicare Value Plan (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H3597 -001 -0 | $6.00 | $33.00 | $45.00 | $45.00 | 3,158 2012 Formulary | ||
2013 Aetna Medicare Value Plan (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $33.00 | $45.00 | $45.00 | 3,323 2013 Formulary | |||
2012 Martin's Point Generations Advantage Value (HMO) | $0.00 | $3,400 | No Rx Coverage | H5591 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Martin's Point Generations Advantage Value (HMO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H5619 -007 -0 | |||||||||||
2013 Humana Gold Plus H5619-007 (HMO) | $20.00 | $4,950 | $0 | Few Generics, Few Brands | $5.00 | $12.00 | $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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2012 Today's Options Advantage 400 (PPO) | $10.00 | $6,700 | No Rx Coverage | H2775 -096 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Advantage 600 (PPO) | $20.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Northeast Community Care - Dual Plus (HMO SNP) | $27.70 | n/a | $320 | No additional gap coverage, only the Donut Hole Discount | H5619 -003 -0 | n/a | ||||||
2013 Humana Gold Plus SNP-DE H5619-003 (HMO SNP) | $33.30 | n/a | $325 | n/a | $0.00 | $45.00 | $95.00 | $95.00 | 3,906 2013 Formulary | |||
2012 Martin's Point Generations Advantage Prime (HMO-POS) | $49.00 | $2,800 | $0 | No additional gap coverage, only the Donut Hole Discount | H5591 -001 -0 | $5.00 | $40.00 | $70.00 | $70.00 | 3,055 2012 Formulary | ||
2013 Martin's Point Generations Advantage Prime (HMO-POS) | $49.00 | $3,200 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $40.00 | $40.00 | 2,952 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 Today's Options Advantage Plus 450G (PPO) | $36.00 | $6,700 | $90 | No additional gap coverage, only the Donut Hole Discount | H2775 -084 -0 | n/a | ||||||
2013 Today's Options Advantage Plus 650B (PPO) | $51.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | |||
2012 Aetna Medicare Standard Plan (HMO) | $56.00 | $3,400 | $0 | Many Generics | H3597 -002 -0 | $4.00 | $33.00 | $45.00 | $45.00 | 3,158 2012 Formulary | ||
2013 Aetna Medicare Standard Plan (HMO) | $56.00 | $3,400 | $0 | Some Generics | $6.00 | $33.00 | $45.00 | $45.00 | 3,323 2013 Formulary | |||
2012 Martin's Point Generations Advantage Select (PPO) | $65.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H1365 -002 -0 | $5.00 | $40.00 | $70.00 | $70.00 | 3,055 2012 Formulary | ||
2013 Martin's Point Generations Advantage Select (PPO) | $65.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $40.00 | $40.00 | 2,952 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 -- |
H6786 -001 -0 | |||||||||||
new | new | new | ||||||||||
2013 Anthem Medicare Preferred Premier (PPO) | $95.00 | $6,000 | $100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $39.00 | $39.00 | 2,838 2013 Formulary | |||
2012 Today's Options Advantage Plus 150A (PPO) | $101.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H2775 -098 -0 | n/a | ||||||
2013 Today's Options Advantage Plus 250A (PPO) | $116.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | |||
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