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 -- |
R6801 -022 -0 | |||||||||||
2013 Care Improvement Plus Copper RX (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | |||
2012 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | ||
2013 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | |||
2012 Care Improvement Plus Medicare Advantage (Regional PPO) | $59.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -012 -0 | $9.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | ||
2013 Care Improvement Plus Medicare Advantage (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 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 R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Humana Gold Choice H8145-126 (PFFS) | $0.00 | $5,000 | No Rx Coverage | H8145 -126 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Humana Gold Choice H8145-126 (PFFS) | $10.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H7811 -001 -0 | |||||||||||
new | new | new | ||||||||||
2013 Texas Community Care - Plus (HMO) | $23.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $11.00 | $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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-- This plan not offered in 2012 -- |
R6801 -021 -0 | |||||||||||
2013 Care Improvement Plus Chrome RX (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | |||
2012 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $30.00 | n/a | $215 | No additional gap coverage, only the Donut Hole Discount | R6801 -011 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | ||
2013 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | |||
2012 Care Improvement Plus Silver Rx (Regional PPO SNP) | $30.00 | n/a | $165 | No additional gap coverage, only the Donut Hole Discount | R6801 -008 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,159 2012 Formulary | ||
2013 Care Improvement Plus Silver Rx (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,401 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 H4520-006 (PPO) | $49.00 | $3,400 | $0 | Few Generics, Few Brands |
H4520 -006 -0 | $7.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 Humana Prime Choice H4520-006 (PPO) | $57.00 | $4,500 | $0 | Few Generics, Few Brands | $7.00 | $12.00 | $42.00 | $42.00 | 3,906 2013 Formulary | |||
2012 HumanaChoice R5826-012 (Regional PPO) | $54.00 | $5,000 | $0 | Few Generics, Few Brands |
R5826 -012 -0 | $7.00 | $42.00 | $82.00 | $82.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-012 (Regional PPO) | $59.00 | $6,700 | $125 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Today's Options Premier 400 (PFFS) | $84.00 | $6,700 | No Rx Coverage | H6169 -015 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2013 Today's Options Premier 600 (PFFS) | $64.00 | 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 Humana Gold Choice H8145-084 (PFFS) | $79.00 | $5,000 | $0 | Few Generics, Few Brands |
H8145 -084 -0 | $6.00 | $38.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-084 (PFFS) | $87.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $12.00 | $39.00 | $39.00 | 3,906 2013 Formulary | |||
2012 Today's Options Premier 200 (PFFS) | $120.00 | $3,250 | No Rx Coverage | H6169 -052 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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2013 Today's Options Premier 300 (PFFS) | $100.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Today's Options Premier Plus 450C (PFFS) | $121.00 | $6,700 | $35 | No additional gap coverage, only the Donut Hole Discount | H6169 -035 -0 | n/a | ||||||
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2013 Today's Options Premier Plus 650C (PFFS) | $106.00 | n/a | $75 | 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) | $187.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H6169 -056 -0 | n/a | ||||||
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2013 Today's Options Premier Plus 350A (PFFS) | $172.00 | 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 | H8098 -001 -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 | H8098 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2013 -- |
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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 Universal Hassle-Free (PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5096 -001 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,148 2012 Formulary | ||
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-- This plan not offered in 2013 -- |
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2012 Universal Hassle-Free MA Only (PPO) | $0.00 | $6,700 | No Rx Coverage | H5096 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
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-- This plan not offered in 2013 -- |
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