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 Advocare Essence (HMO-POS) | $0.00 | $3,400 | No Rx Coverage | H5211 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Advocare Essence (HMO-POS) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2012 -- |
H8145 -153 -0 | |||||||||||
2013 Humana Gold Choice H8145-153 (PFFS) | $0.00 | $4,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
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. | ||||||||
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 Network PlatinumSelect (PPO) | $0.00 | $2,900 | $0 | No additional gap coverage, only the Donut Hole Discount | H5215 -008 -0 | $7.00 | $35.00 | $65.00 | $65.00 | 4,947 2012 Formulary | ||
2013 Network PlatinumSelect (PPO) | $0.00 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $8.00 | $40.00 | $40.00 | 5,243 2013 Formulary | |||
-- This plan not offered in 2012 -- |
H8189 -001 -0 | |||||||||||
-- | -- | -- | ||||||||||
2013 Advantage by Managed Health Services (HMO SNP) | $36.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 3,010 2013 Formulary | |||
2012 NetworkCares (PPO SNP) | $36.70 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5215 -007 -0 | $6.00 | $39.00 | $87.00 | $87.00 | 4,947 2012 Formulary | ||
2013 NetworkCares (PPO SNP) | $38.30 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $10.00 | $42.00 | $42.00 | 5,243 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 Network PlatinumPlus (PPO) | $36.00 | $2,700 | No Rx Coverage | H5215 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Network PlatinumPlus (PPO) | $42.00 | $2,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Advocare Essence Rx (HMO-POS) | $39.00 | $3,400 | $0 | Few Generics | H5211 -002 -0 | $6.00 | $35.00 | $70.00 | $70.00 | 4,262 2012 Formulary | ||
2013 Advocare Essence Rx (HMO-POS) | $47.00 | $3,400 | $0 | Few Generics | $6.00 | $45.00 | $90.00 | $90.00 | 4,639 2013 Formulary | |||
2012 HumanaChoice H5216-003 (PPO) | $41.00 | $4,500 | $0 | Few Generics, Few Brands |
H5216 -003 -0 | $6.00 | $40.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H5216-003 (PPO) | $52.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $45.00 | $95.00 | $95.00 | 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 |
||||||
-- This plan not offered in 2012 -- |
H4036 -005 -0 | |||||||||||
2013 Anthem Medicare Preferred Standard (PPO) | $61.00 | $4,200 | $92 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $42.00 | $42.00 | 2,838 2013 Formulary | |||
2012 Humana Gold Choice H8145-006 (PFFS) | $61.00 | $6,000 | $0 | Few Generics, Few Brands |
H8145 -006 -0 | $7.00 | $41.00 | $80.00 | $80.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H8145-006 (PFFS) | $72.00 | n/a | $0 | Few Generics, Few Brands | $7.00 | $41.00 | $80.00 | $80.00 | 3,906 2013 Formulary | |||
2012 Network PlatinumPlus Pharmacy (PPO) | $74.00 | $2,700 | $0 | Many Generics | H5215 -002 -0 | $7.00 | $35.00 | $65.00 | $65.00 | 4,947 2012 Formulary | ||
2013 Network PlatinumPlus Pharmacy (PPO) | $83.00 | $2,500 | $0 | Many Generics | $1.00 | $8.00 | $40.00 | $40.00 | 5,243 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 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 Advocare Spirit (HMO-POS) | $118.00 | $900 | No Rx Coverage | H5211 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Advocare Spirit (HMO-POS) | $118.00 | $1,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Network PlatinumPremier (PPO) | $77.00 | $2,000 | No Rx Coverage | H5215 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Network PlatinumPremier (PPO) | $145.00 | $2,000 | 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 Advocare Spirit Rx (HMO-POS) | $167.00 | $900 | $0 | Few Generics | H5211 -004 -0 | $6.00 | $35.00 | $70.00 | $70.00 | 4,262 2012 Formulary | ||
2013 Advocare Spirit Rx (HMO-POS) | $173.00 | $1,000 | $0 | Few Generics | $6.00 | $45.00 | $90.00 | $90.00 | 4,639 2013 Formulary | |||
2012 Advocare Vitality (HMO-POS) | $192.00 | n/a | No Rx Coverage | H5211 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Advocare Vitality (HMO-POS) | $215.00 | $500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Network PlatinumPremier Pharmacy (PPO) | $135.00 | $2,000 | $0 | Many Generics | H5215 -005 -0 | $7.00 | $35.00 | $65.00 | $65.00 | 4,947 2012 Formulary | ||
2013 Network PlatinumPremier Pharmacy (PPO) | $215.00 | $2,000 | $0 | Many Generics | $1.00 | $8.00 | $40.00 | $40.00 | 5,243 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 Advocare Vitality Rx (HMO-POS) | $254.00 | n/a | $0 | Few Generics | H5211 -005 -0 | $6.00 | $35.00 | $70.00 | $70.00 | 4,262 2012 Formulary | ||
2013 Advocare Vitality Rx (HMO-POS) | $286.00 | $500 | $0 | Few Generics | $6.00 | $45.00 | $90.00 | $90.00 | 4,639 2013 Formulary | |||
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