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 AARP MedicareComplete Choice Essential (Regional PPO) | $0.00 | $3,500 | No Rx Coverage | R5287 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 AARP MedicareComplete Choice Essential (Regional PPO) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 AARP MedicareComplete Choice Plan 2 (Regional PPO) | $0.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | R5287 -001 -0 | $0.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
2014 AARP MedicareComplete Choice Plan 2 (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
2013 BlueMedicare Regional PPO (Regional PPO) | $0.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | R3332 -001 -0 | $6.00 | $10.00 | $45.00 | $45.00 | 3,729 2013 Formulary | ||
2014 BlueMedicare Regional PPO (Regional PPO) | $0.00 | $6,700 | $30 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $33.00 | $45.00 | $45.00 | 3,663 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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-- This plan not offered in 2013 -- |
H5410 -004 -0 | |||||||||||
2014 Cigna-HealthSpring Advantage (HMO) | $0.00 | $5,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HealthSpring Premier Bay (HMO-POS) | $39.50 | $2,950 | $0 | Many Generics | H5410 -018 -0 | $3.00 | $6.00 | $45.00 | $45.00 | 3,056 2013 Formulary | ||
2014 Cigna-HealthSpring Premier (HMO-POS) | $0.00 | $5,500 | $0 | Many Generics | $3.00 | $12.00 | $45.00 | $45.00 | 2,946 2014 Formulary | |||
2013 HumanaChoice R5826-018 (Regional PPO) | $0.00 | $4,000 | No Rx Coverage | R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-018 (Regional PPO) | $0.00 | $4,000 | 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 |
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2013 Humana Reader's Digest Healthy Living Plan (Regional PPO) | $0.00 | $4,950 | $0 | Few Generics, Few Brands |
R5826 -074 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-074 (Regional PPO) | $0.00 | $5,900 | $150 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 WellCare Advance (HMO) | $0.00 | $3,400 | No Rx Coverage | H1032 -037 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 WellCare Advance (HMO) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 WellCare Value (HMO) | $0.00 | $6,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H1032 -079 -0 | $3.00 | $39.00 | $79.00 | $79.00 | 2,835 2013 Formulary | ||
2014 WellCare Value (HMO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $35.00 | $35.00 | 2,844 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 WellCare Liberty (HMO SNP) | $8.70 | n/a | $325 | n/a | H1032 -124 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
2014 WellCare Liberty (HMO SNP) | $9.40 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $35.00 | $35.00 | 2,844 2014 Formulary | |||
2013 WellCare Access (HMO SNP) | $12.10 | n/a | $325 | n/a | H1032 -175 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
2014 WellCare Access (HMO SNP) | $10.40 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $35.00 | $35.00 | 2,844 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H5410 -013 -0 | |||||||||||
2014 Cigna-HealthSpring TotalCare (HMO SNP) | $21.10 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 2,946 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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-- This plan not offered in 2013 -- |
R5287 -003 -0 | |||||||||||
2014 UnitedHealthcare Dual Complete RP (Regional PPO SNP) | $21.80 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,604 2014 Formulary | |||
2013 HumanaChoice R5826-005 (Regional PPO) | $85.00 | $4,750 | $0 | Few Generics, Few Brands |
R5826 -005 -0 | $3.00 | $8.00 | $40.00 | $40.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-005 (Regional PPO) | $92.00 | $5,700 | $0 | Few Generics, Few Brands | $3.00 | $8.00 | $40.00 | $40.00 | 3,711 2014 Formulary | |||
2013 HealthSpring Advantage Bay (HMO) | $0.00 | $3,400 | No Rx Coverage | H5410 -015 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- Members will be assigned to Cigna-HealthSpring Advantage (HMO) H5410-004 -- | ||||||||||||
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 HealthSpring Preferred Bay (HMO) | $0.00 | $3,400 | $0 | Many Generics | H5410 -017 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,056 2013 Formulary | ||
-- Members will be assigned to Cigna-HealthSpring Premier (HMO-POS) H5410-0018 -- | ||||||||||||
2013 HealthSpring TotalCare Bay (HMO SNP) | $24.80 | n/a | $325 | n/a | H5410 -016 -0 | 25% | 3,025 2013 Formulary | |||||
-- Members will be assigned to Cigna-HealthSpring TotalCare (HMO SNP) H5410-0013 -- | ||||||||||||
2013 Today's Options Premier 600 (PFFS) | $90.00 | n/a | No Rx Coverage | H5421 -057 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- 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 650J (PFFS) | $107.00 | n/a | $130 | No additional gap coverage, only the Donut Hole Discount | H5421 -075 -0 | $5.00 | $10.50 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Today's Options Premier 300 (PFFS) | $125.00 | n/a | No Rx Coverage | H5421 -211 -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 350A (PFFS) | $164.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -215 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 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 |
||||||
2013 WellCare Select (HMO-POS SNP) | $12.50 | n/a | $325 | n/a | H1032 -101 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 UnitedHealthcare Dual Complete RP (Regional PPO SNP) | $24.80 | n/a | $325 | n/a | R5287 -003 -0 | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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