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 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 | |||
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 HealthSpring Advantage NGA (HMO) | $0.00 | $3,400 | No Rx Coverage | H2165 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Cigna-HealthSpring Advantage NGA (HMO) | $0.00 | $3,400 | 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 HealthSpring Preferred NGA (HMO) | $0.00 | $3,400 | $0 | Many Generics | H2165 -005 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,056 2013 Formulary | ||
2014 Cigna-HealthSpring Preferred NGA (HMO) | $0.00 | $3,400 | $0 | Many Generics | $3.00 | $12.00 | $45.00 | $45.00 | 2,946 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. | ||||||||
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 | |||
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 Humana Gold Plus SNP-DE H4141-007 (HMO SNP) | $31.10 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H4141 -007 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DE H4141-007 (HMO SNP) | $17.10 | n/a | $100 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
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 Humana Gold Plus H4141-008 (HMO) | $31.00 | $4,250 | $0 | Few Generics, Few Brands |
H4141 -008 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H4141-008 (HMO) | $37.00 | $4,900 | $0 | Few Generics, Few Brands | $5.00 | $10.00 | $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 H4408-006 (PPO) | $51.00 | $5,300 | $0 | Few Generics, Few Brands |
H4408 -006 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice H4408-006 (PPO) | $64.00 | $6,700 | $100 | Few Generics, Few Brands | $6.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 HealthSpring Premier NGA (HMO-POS) | $26.00 | $3,400 | $0 | Many Generics | H2165 -011 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,056 2013 Formulary | ||
2014 Cigna-HealthSpring Premier NGA (HMO-POS) | $72.00 | $3,400 | $0 | Many Generics | $3.00 | $12.00 | $45.00 | $45.00 | 2,946 2014 Formulary | |||
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 | |||
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 Gold Plus H4141-006 (HMO) | $101.00 | $4,250 | $0 | Few Generics, Few Brands |
H4141 -006 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H4141-006 (HMO) | $107.00 | $4,250 | $0 | Few Generics, Few Brands | $4.00 | $8.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
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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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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