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 Humana Gold Plus H2012-011 (HMO) | $0.00 | $4,900 | $0 | Few Generics, Few Brands |
H2012 -011 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H2012-011 (HMO) | $0.00 | $4,900 | $0 | Few Generics, Few Brands | $5.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | R5826 -066 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-066 (Regional PPO) | $0.00 | $5,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 WellCare Value (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H9730 -002 -0 | $3.00 | $35.00 | $70.00 | $70.00 | 2,835 2013 Formulary | ||
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2014 WellCare Value (HMO-POS) | $0.00 | $5,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $13.00 | $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 Access (HMO SNP) | $16.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H9730 -001 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
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2014 WellCare Access (HMO SNP) | $18.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $15.00 | $15.00 | 2,844 2014 Formulary | |||
2013 Anthem Senior Advantage Value (HMO) | $25.00 | $3,400 | $90 | No additional gap coverage, only the Donut Hole Discount | H1849 -015 -0 | $5.00 | $9.00 | $41.00 | $41.00 | 4,173 2013 Formulary | ||
2014 Anthem Senior Advantage Value (HMO) | $30.00 | $4,900 | $150 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $14.00 | $40.00 | $40.00 | 2,998 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H6609 -078 -0 | |||||||||||
2014 HumanaChoice H6609-078 (PPO) | $47.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $18.00 | $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 Anthem Medicare Preferred Standard (PPO) | $40.00 | $5,200 | $60 | No additional gap coverage, only the Donut Hole Discount | H5530 -001 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 4,173 2013 Formulary | ||
2014 Anthem Medicare Preferred Standard (PPO) | $56.00 | $5,900 | $135 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $16.00 | $40.00 | $40.00 | 2,998 2014 Formulary | |||
2013 Blue Medicare Access Value (Regional PPO) | $34.00 | $6,500 | $80 | No additional gap coverage, only the Donut Hole Discount | R5941 -009 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 4,173 2013 Formulary | ||
2014 Blue Medicare Access Value (Regional PPO) | $63.00 | $6,500 | $100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $40.00 | $40.00 | 3,391 2014 Formulary | |||
2013 HumanaChoice R5826-008 (Regional PPO) | $66.00 | $6,700 | $0 | Few Generics, Few Brands |
R5826 -008 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-008 (Regional PPO) | $66.00 | $6,700 | $0 | Few Generics, Few Brands | $6.00 | $18.00 | $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 Choice H8145-021 (PFFS) | $82.00 | n/a | $0 | Few Generics, Few Brands |
H8145 -021 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Choice H8145-021 (PFFS) | $85.00 | n/a | $0 | Few Generics, Few Brands | $7.00 | $18.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H6609 -079 -0 | |||||||||||
2014 HumanaChoice H6609-079 (PPO) | $148.00 | $5,000 | $150 | Few Generics, Few Brands | $6.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Anthem Medicare Preferred Select (PPO) | $69.00 | $4,200 | $60 | No additional gap coverage, only the Donut Hole Discount | H5530 -004 -0 | $4.00 | $8.00 | $45.00 | $45.00 | 4,173 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 HumanaChoice H1806-002 (PPO) | $46.00 | $6,700 | $0 | Few Generics, Few Brands |
H1806 -002 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Anthem Senior Advantage Complete (HMO) | $50.00 | $3,400 | $90 | No additional gap coverage, only the Donut Hole Discount | H1849 -016 -0 | $5.00 | $9.00 | $41.00 | $41.00 | 4,173 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 HumanaChoice H1806-007 (PPO) | $130.00 | $5,000 | $0 | Few Generics, Few Brands |
H1806 -007 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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