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 -- |
H6609 -004 -0 | |||||||||||
2013 HumanaChoice H6609-004 (PPO) | $0.00 | $4,000 | 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. | ||||||||
2012 UnitedHealthcare MedicareDirect Rx (PFFS) | $28.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5435 -014 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,614 2012 Formulary | ||
2013 UnitedHealthcare MedicareDirect Rx (PFFS) | $28.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $44.00 | $44.00 | 3,825 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 H2944-019 (PFFS) | $37.00 | $5,400 | $0 | Few Generics, Few Brands |
H2944 -019 -0 | $7.00 | $40.00 | $77.00 | $77.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H2944-019 (PFFS) | $47.00 | n/a | $150 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H6609 -017 -0 | |||||||||||
2013 HumanaChoice H6609-017 (PPO) | $58.00 | $4,000 | $325 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $10.00 | $40.00 | $40.00 | 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. | ||||||||
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 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. | ||||||||
-- This plan not offered in 2012 -- |
H3283 -003 -0 | |||||||||||
-- | -- | -- | ||||||||||
2013 Medica Clear Solution Essential (PPO) | $102.00 | $3,400 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 5,138 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 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 Medica Clear Solution with Part D Option 1 (PPO) | $262.70 | $2,500 | $320 | No additional gap coverage, only the Donut Hole Discount | H3283 -001 -0 | 25% | 25% | 25% | 25% | 4,886 2012 Formulary | ||
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2013 Medica Clear Solution Premier (PPO) | $206.70 | $2,500 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 5,138 2013 Formulary | |||
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