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 -- |
H3456 -020 -0 | |||||||||||
2013 AARP MedicareComplete Essential (HMO) | $0.00 | $3,900 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $4,750 | $0 | No additional gap coverage, only the Donut Hole Discount | H3456 -025 -0 | $3.00 | $6.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 AARP MedicareComplete Plus (HMO-POS) | $0.00 | $4,750 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | |||
2012 Humana Gold Choice H8145-114 (PFFS) | $15.00 | $6,700 | No Rx Coverage | H8145 -114 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Humana Gold Choice H8145-114 (PFFS) | $0.00 | n/a | 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 HumanaChoice R5826-063 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -063 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-063 (Regional PPO) | $0.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Presidential (PFFS) | $0.00 | $3,400 | No Rx Coverage | H0979 -021 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Presidential (PFFS) | $0.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 UnitedHealthcare MedicareDirect Essential (PFFS) | $0.00 | $6,200 | No Rx Coverage | H5435 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 UnitedHealthcare MedicareDirect Essential (PFFS) | $0.00 | n/a | 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 UnitedHealthcare MedicareDirect Rx (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5435 -024 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 UnitedHealthcare MedicareDirect Rx (PFFS) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $45.00 | $45.00 | 3,825 2013 Formulary | |||
2012 HumanaChoice H3405-007 (PPO) | $21.00 | $3,900 | $0 | Few Generics, Few Brands |
H3405 -007 -0 | $6.00 | $42.00 | $85.00 | $85.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H3405-007 (PPO) | $24.00 | $3,900 | $0 | Few Generics, Few Brands | $4.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Presidential Plus (PFFS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H0979 -022 -0 | $6.00 | $45.00 | $80.00 | $80.00 | 2,608 2012 Formulary | ||
2013 Presidential Plus (PFFS) | $26.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $44.00 | $78.00 | $78.00 | 2,764 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 Humana Gold Choice H8145-063 (PFFS) | $42.00 | $5,500 | $0 | Few Generics, Few Brands |
H8145 -063 -0 | $7.00 | $41.00 | $85.00 | $85.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-063 (PFFS) | $47.00 | n/a | $0 | Few Generics, Few Brands | $2.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Today's Options Premier 400 (PFFS) | $60.00 | $6,700 | No Rx Coverage | H5421 -049 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 600 (PFFS) | $60.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice R5826-079 (Regional PPO) | $58.00 | $5,900 | $320 | No additional gap coverage, only the Donut Hole Discount | R5826 -079 -0 | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-079 (Regional PPO) | $63.00 | $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 HumanaChoice R5826-003 (Regional PPO) | $69.00 | $5,900 | $0 | Few Generics, Few Brands |
R5826 -003 -0 | $8.00 | $45.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-003 (Regional PPO) | $75.00 | $6,200 | $0 | Few Generics, Few Brands | $5.00 | $11.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Today's Options Premier Plus 450D (PFFS) | $82.00 | $6,700 | $50 | No additional gap coverage, only the Donut Hole Discount | H5421 -073 -0 | n/a | ||||||
2013 Today's Options Premier Plus 650H (PFFS) | $87.00 | n/a | $87 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | |||
2012 Today's Options Premier 200 (PFFS) | $95.00 | $3,250 | No Rx Coverage | H5421 -209 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 300 (PFFS) | $95.00 | n/a | 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 Today's Options Premier Plus 250A (PFFS) | $139.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -067 -0 | n/a | ||||||
2013 Today's Options Premier Plus 350A (PFFS) | $144.00 | 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 Any, Any, Any Gold (PFFS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5820 -002 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,148 2012 Formulary | ||
-- This plan not offered in 2013 -- |
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2012 Any, Any, Any Gold MA Only (PFFS) | $0.00 | $6,700 | No Rx Coverage | H5820 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2013 -- |
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