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 R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | R5826 -066 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Blue Medicare Access Value (Regional PPO) | $0.00 | $4,200 | $60 | No additional gap coverage, only the Donut Hole Discount | R5941 -009 -0 | $7.00 | $43.00 | $85.00 | $85.00 | 4,453 2012 Formulary | ||
2013 Blue Medicare Access Value (Regional PPO) | $34.00 | $6,500 | $80 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $45.00 | $45.00 | 4,173 2013 Formulary | |||
2012 HumanaChoice H1510-008 (PPO) | $49.00 | $5,000 | $0 | Few Generics, Few Brands |
H1510 -008 -0 | $7.00 | $40.00 | $86.00 | $86.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice H1510-008 (PPO) | $47.00 | $5,900 | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $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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2012 Today's Options Premier 400 (PFFS) | $60.00 | $6,700 | No Rx Coverage | H5421 -049 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 600 (PFFS) | $60.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 HumanaChoice R5826-008 (Regional PPO) | $71.00 | $6,700 | $200 | No additional gap coverage, only the Donut Hole Discount | R5826 -008 -0 | $7.00 | $35.00 | $60.00 | $60.00 | 3,798 2012 Formulary | ||
2013 HumanaChoice R5826-008 (Regional PPO) | $66.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | |||
2012 Humana Gold Choice H2944-124 (PFFS) | $59.00 | $6,700 | $0 | Few Generics, Few Brands |
H2944 -124 -0 | $8.00 | $40.00 | $82.00 | $82.00 | 3,798 2012 Formulary | ||
2013 Humana Gold Choice H2944-124 (PFFS) | $72.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $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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2012 Today's Options Premier Plus 450D (PFFS) | $82.00 | $6,700 | $50 | No additional gap coverage, only the Donut Hole Discount | H5421 -073 -0 | n/a | ||||||
2013 Today's Options Premier Plus 650H (PFFS) | $87.00 | n/a | $87 | 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 200 (PFFS) | $95.00 | $3,250 | No Rx Coverage | H5421 -209 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2013 Today's Options Premier 300 (PFFS) | $95.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2012 Today's Options Premier Plus 250A (PFFS) | $139.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -067 -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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