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 Advantra Preferred (PPO) | $0.00 | $4,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H9847 -005 -0 | $3.00 | $18.00 | $45.00 | $45.00 | 3,224 2013 Formulary | ||
2014 Advantra Preferred (PPO) | $0.00 | $4,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $18.00 | $42.00 | $42.00 | 3,177 2014 Formulary | |||
2013 Advantra Silver (HMO-POS) | $0.00 | $5,100 | $0 | No additional gap coverage, only the Donut Hole Discount | H5302 -003 -0 | $3.00 | $18.00 | $45.00 | $45.00 | 3,224 2013 Formulary | ||
2014 Advantra Silver (HMO-POS) | $0.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $22.00 | $42.00 | $42.00 | 3,177 2014 Formulary | |||
2013 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $9.00 | $45.00 | $45.00 | 3,604 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 Care Improvement Plus Medicare Advantage (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -012 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Medicare Advantage (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
2013 Humana Gold Plus H4141-012 (HMO) | $0.00 | $4,950 | $0 | Few Generics, Few Brands |
H4141 -012 -0 | $2.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H4141-012 (HMO) | $0.00 | $6,700 | $70 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 HumanaChoice R5826-064 (Regional PPO) | $0.00 | $4,900 | No Rx Coverage | R5826 -064 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-064 (Regional PPO) | $0.00 | $5,900 | 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 WellCare Value (HMO-POS) | $0.00 | $4,500 | $0 | No additional gap coverage, only the Donut Hole Discount | H1112 -027 -0 | $3.00 | $39.00 | $75.00 | $75.00 | 2,835 2013 Formulary | ||
2014 WellCare Value (HMO-POS) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $35.00 | $35.00 | 2,844 2014 Formulary | |||
2013 Care Improvement Plus Silver Rx (Regional PPO SNP) | $36.30 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R9896 -008 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Silver Rx (Regional PPO SNP) | $14.60 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,604 2014 Formulary | |||
2013 WellCare Access (HMO SNP) | $17.90 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1112 -006 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
2014 WellCare Access (HMO SNP) | $17.20 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $15.00 | $15.00 | 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 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $36.50 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R9896 -021 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $31.50 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,604 2014 Formulary | |||
2013 Medicare Preferred Core (PPO) | $25.00 | $5,500 | $91 | No additional gap coverage, only the Donut Hole Discount | H9947 -001 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 4,173 2013 Formulary | ||
2014 Medicare Preferred Core (PPO) | $35.00 | $5,500 | $125 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $16.00 | $40.00 | $40.00 | 2,998 2014 Formulary | |||
2013 HumanaChoice H5214-012 (PPO) | $33.00 | $4,950 | $0 | Few Generics, Few Brands |
H5214 -012 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice H5214-012 (PPO) | $40.00 | $5,500 | $0 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 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 HumanaChoice R5826-077 (Regional PPO) | $79.00 | $6,200 | $150 | No additional gap coverage, only the Donut Hole Discount | R5826 -077 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-077 (Regional PPO) | $77.00 | $6,700 | $150 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Medicare Preferred Premier (PPO) | $60.00 | $4,500 | $91 | No additional gap coverage, only the Donut Hole Discount | H9947 -002 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 4,173 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Care Improvement Plus Chrome RX (Regional PPO SNP) | $36.50 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R9896 -022 -0 | 25% | 25% | 25% | 25% | 3,401 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 Care Improvement Plus Copper RX (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R9896 -023 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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