2013 / 2014 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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2013 Health Alliance Medicare HMO Basic (HMO-POS) | $0.00 | $3,400 | No Rx Coverage | H1463 -008 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Health Alliance Medicare HMO Basic (HMO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HumanaChoice R5826-023 (Regional PPO) | $0.00 | $4,500 | No Rx Coverage | R5826 -023 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-023 P (Regional PPO) | $0.00 | $4,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2013 -- |
H7301 -002 -0 | |||||||||||
2014 Advantra (PPO) | $29.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,177 2014 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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2013 Health Alliance Medicare HMO Basic Rx (HMO-POS) | $34.00 | $3,400 | $150 | No additional gap coverage, only the Donut Hole Discount | H1463 -009 -0 | $0.00 | $33.00 | $45.00 | $45.00 | 5,230 2013 Formulary | ||
2014 Health Alliance Medicare HMO Basic Rx (HMO) | $33.00 | $3,400 | $290 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2013 Health Alliance Medicare PPO30 (PPO) | $35.00 | $3,000 | No Rx Coverage | H1417 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Health Alliance Medicare PPO30 (PPO) | $40.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Health Alliance Medicare PPO30 Rx (PPO) | $69.00 | $3,000 | $180 | No additional gap coverage, only the Donut Hole Discount | H1417 -004 -0 | $0.00 | $33.00 | $45.00 | $45.00 | 5,230 2013 Formulary | ||
2014 Health Alliance Medicare PPO30 Rx (PPO) | $73.00 | $3,000 | $230 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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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2013 Health Alliance Medicare HMO20 (HMO) | $75.00 | $1,500 | No Rx Coverage | H1463 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Health Alliance Medicare HMO20 (HMO) | $85.00 | $1,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Health Alliance Medicare PPO10 (PPO) | $100.00 | $1,500 | No Rx Coverage | H1417 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Health Alliance Medicare PPO10 (PPO) | $110.00 | $1,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HumanaChoice R5826-009 (Regional PPO) | $89.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | R5826 -009 -0 | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-009 P (Regional PPO) | $112.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,711 2014 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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2013 Health Alliance Medicare HMO20 Rx (HMO) | $119.00 | $1,500 | $130 | No additional gap coverage, only the Donut Hole Discount | H1463 -003 -0 | $0.00 | $33.00 | $45.00 | $45.00 | 5,230 2013 Formulary | ||
2014 Health Alliance Medicare HMO20 Rx (HMO) | $117.00 | $1,500 | $270 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2013 Health Alliance Medicare PPO10 Rx (PPO) | $144.00 | $1,500 | $140 | No additional gap coverage, only the Donut Hole Discount | H1417 -002 -0 | $0.00 | $33.00 | $45.00 | $45.00 | 5,230 2013 Formulary | ||
2014 Health Alliance Medicare PPO10 Rx (PPO) | $145.00 | $1,500 | $230 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2013 Humana Gold Choice H2944-041 (PFFS) | $114.00 | n/a | $0 | Few Generics, Few Brands | H2944 -041 -0 | $7.00 | $40.00 | $80.00 | $80.00 | 3,906 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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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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2013 Today's Options Premier Plus 350A (PFFS) | $144.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -067 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Today's Options Premier 600 (PFFS) | $60.00 | n/a | No Rx Coverage | H5421 -049 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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2013 Today's Options Premier Plus 650H (PFFS) | $87.00 | n/a | $87 | No additional gap coverage, only the Donut Hole Discount | H5421 -073 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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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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2013 Today's Options Premier 300 (PFFS) | $95.00 | n/a | No Rx Coverage | H5421 -209 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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