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 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) | $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 Humana Gold Choice H2944-178 (PFFS) | $0.00 | $5,000 | No Rx Coverage | H2944 -178 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Humana Gold Choice H2944-178 (PFFS) | $19.00 | 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 400 (PFFS) | $25.00 | $6,700 | No Rx Coverage | H5421 -047 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 600 (PFFS) | $45.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Humana Gold Choice H2944-004 (PFFS) | $50.00 | $5,000 | $0 | Few Generics, Few Brands |
H2944 -004 -0 | $6.00 | $39.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H2944-004 (PFFS) | $64.00 | n/a | $250 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $37.00 | $37.00 | 3,906 2013 Formulary | |||
2012 Today's Options Premier 200 (PFFS) | $60.00 | $3,250 | No Rx Coverage | H5421 -207 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 300 (PFFS) | $80.00 | 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 450B (PFFS) | $60.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -065 -0 | n/a | ||||||
2013 Today's Options Premier Plus 650I (PFFS) | $85.00 | n/a | $85 | 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 Plus 250A (PFFS) | $119.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -213 -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 | |||
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