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 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $4,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice H5216-006 (PPO) | $31.00 | $4,500 | $0 | Few Generics, Few Brands |
H5216 -006 -0 | $6.00 | $34.00 | $75.00 | $75.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H5216-006 (PPO) | $42.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $34.00 | $75.00 | $75.00 | 3,906 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H4270 -005 -0 | |||||||||||
2013 UCare for Seniors Essentials (HMO-POS) | $43.00 | $3,400 | 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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-- This plan not offered in 2012 -- |
H4270 -006 -0 | |||||||||||
2013 UCare for Seniors Essentials Rx (HMO-POS) | $57.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $20.00 | $45.00 | $45.00 | 5,011 2013 Formulary | |||
2012 UCare for Seniors Value (HMO-POS) | $61.00 | $3,400 | No Rx Coverage | H4270 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 UCare for Seniors Value (HMO-POS) | $60.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 UCare for Seniors Standard D (HMO-POS) | $67.00 | $3,400 | $320 | No additional gap coverage, only the Donut Hole Discount | H4270 -004 -0 | 25% | 25% | 2,804 2012 Formulary | ||||
2013 UCare for Seniors Standard D (HMO-POS) | $66.00 | $3,400 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 2,911 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 |
||||||
2012 DeanCare Gold Shared Value (Cost) | $65.00 | n/a | No Rx Coverage | H5264 -005 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 DeanCare Gold Shared Value (Cost) | $68.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice R5826-009 (Regional PPO) | $67.00 | $5,000 | $320 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | 25% | 25% | 25% | 25% | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-009 (Regional PPO) | $89.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | |||
2012 Medical Associates SmartPlan (Cost) | $97.00 | n/a | No Rx Coverage | H5256 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Medical Associates SmartPlan (Cost) | $98.00 | 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 |
||||||
2012 UCare for Seniors Value Plus (HMO-POS) | $89.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H4270 -003 -0 | $10.00 | $35.00 | $70.00 | $70.00 | 4,776 2012 Formulary | ||
2013 UCare for Seniors Value Plus (HMO-POS) | $98.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $40.00 | $40.00 | 5,011 2013 Formulary | |||
2012 DeanCare Gold Basic (Cost) | $103.00 | n/a | No Rx Coverage | H5264 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 DeanCare Gold Basic (Cost) | $108.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 DeanCare Gold Enhanced (Cost) | $108.00 | n/a | No Rx Coverage | H5264 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 DeanCare Gold Enhanced (Cost) | $113.00 | 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 Medical Associates Community Plan (Cost) | $125.00 | n/a | No Rx Coverage | H5256 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Medical Associates Community Plan (Cost) | $127.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Medical Associates Freedom Plan (Cost) | $125.00 | n/a | No Rx Coverage | H5256 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Medical Associates Freedom Plan (Cost) | $127.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
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