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 HumanaChoice R5826-065 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -065 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-065 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HumanaChoice R5826-001 (Regional PPO) | $62.00 | $4,900 | $100 | No additional gap coverage, only the Donut Hole Discount | R5826 -001 -0 | $8.00 | $8.00 | $38.00 | $38.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-001 (Regional PPO) | $69.00 | $5,900 | $40 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Blue Advantage Complete (PPO) | $103.00 | $3,400 | $290 | No additional gap coverage, only the Donut Hole Discount | H0104 -011 -3 | $4.00 | $10.00 | $45.00 | $45.00 | 2,905 2013 Formulary | ||
2014 Blue Advantage Complete (PPO) | $72.00 | $3,400 | $250 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $45.00 | $45.00 | 2,839 2014 Formulary | |||
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