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 Akamai Advantage Secure (Regional PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | R7439 -001 -0 | $6.00 | $45.00 | $85.00 | $85.00 | 4,885 2013 Formulary | ||
2014 Akamai Advantage Secure (Regional PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $45.00 | $95.00 | $95.00 | 4,779 2014 Formulary | |||
2013 AlohaCare Advantage (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5969 -001 -0 | $4.00 | $7.00 | $40.00 | $40.00 | 3,734 2013 Formulary | ||
2014 AlohaCare Advantage (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $40.00 | $40.00 | 3,717 2014 Formulary | |||
2013 AlohaCare Advantage Plus (HMO SNP) | $33.30 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5969 -002 -0 | 25% | 25% | 3,745 2013 Formulary | ||||
2014 AlohaCare Advantage Plus (HMO SNP) | $25.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 3,726 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 Akamai Advantage Assured (Regional PPO) | $21.00 | $3,400 | No Rx Coverage | R7439 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Akamai Advantage Assured (Regional PPO) | $46.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Akamai Advantage Preferred (Regional PPO) | $65.50 | $3,400 | $150 | No additional gap coverage, only the Donut Hole Discount | R7439 -003 -0 | $4.00 | $30.00 | $65.00 | $65.00 | 4,885 2013 Formulary | ||
2014 Akamai Advantage Preferred (Regional PPO) | $91.00 | $3,400 | $0 | Few Generics | $7.00 | $45.00 | $95.00 | $95.00 | 4,779 2014 Formulary | |||
2013 65C Plus Basic Option (Cost) | $90.00 | n/a | No Rx Coverage | H1251 -001 -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 65C Plus Basic Option BRx (Cost) | $121.40 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1251 -003 -0 | $6.00 | $45.00 | $70.00 | $70.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 65C Plus High Option (Cost) | $94.00 | n/a | No Rx Coverage | H1251 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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2013 65C Plus High Option SRx (Cost) | $138.10 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1251 -004 -0 | $4.00 | $30.00 | $65.00 | $65.00 | 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 UnitedHealthcare MedicareComplete Choice (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | R3175 -001 -0 | $3.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) | $0.00 | $5,900 | No Rx Coverage | R3175 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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2013 UnitedHealthcare Dual Complete RP (Regional PPO SNP) | $33.30 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R3175 -003 -0 | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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