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 Today's Options Premier 400 (PFFS) | $75.00 | $6,700 | No Rx Coverage | H5421 -056 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 600 (PFFS) | $80.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Today's Options Premier 200 (PFFS) | $110.00 | $3,250 | No Rx Coverage | H5421 -210 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 300 (PFFS) | $115.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Today's Options Premier Plus 450E (PFFS) | $108.00 | $6,700 | $65 | No additional gap coverage, only the Donut Hole Discount | H5421 -074 -0 | n/a | ||||||
2013 Today's Options Premier Plus 650D (PFFS) | $118.00 | n/a | $85 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | |||
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) | $165.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -068 -0 | n/a | ||||||
2013 Today's Options Premier Plus 350A (PFFS) | $175.00 | 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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