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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-- This plan not offered in 2013 -- |
H5576 -012 -0 | |||||||||||
2014 AAA6 Vantage CAPITOL (HMO-POS) | $0.00 | $6,700 | $200 | Many Generics | $3.00 | $10.00 | $45.00 | $45.00 | 3,486 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H1367 -002 -0 | |||||||||||
new | new | new | ||||||||||
2014 AmeriHealth VIP Select (HMO) | $0.00 | $6,700 | $100 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $45.00 | $95.00 | $95.00 | 3,172 2014 Formulary | |||
2013 Humana Gold Plus H1951-001 (HMO) | $0.00 | $6,700 | $0 | Some Generics, Few Brands |
H1951 -001 -0 | $5.00 | $8.00 | $35.00 | $35.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H1951-001 (HMO) | $0.00 | $6,700 | $0 | Some Generics, Few Brands | $5.00 | $10.00 | $40.00 | $40.00 | 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 SNP-DB H1951-036 (HMO SNP) | $0.00 | n/a | $0 | Some Generics, Few Brands |
H1951 -036 -0 | $4.00 | $8.00 | $35.00 | $35.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DB H1951-036 (HMO SNP) | $0.00 | n/a | $0 | Some Generics, Few Brands | $5.00 | $10.00 | $40.00 | $40.00 | 3,711 2014 Formulary | |||
2013 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -068 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 UnitedHealthcare MedicareDirect Essential (PFFS) | $0.00 | n/a | No Rx Coverage | H5435 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 UnitedHealthcare MedicareDirect Essential (PFFS) | $0.00 | n/a | 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 UnitedHealthcare MedicareDirect Rx (PFFS) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5435 -024 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
2014 UnitedHealthcare MedicareDirect Rx (PFFS) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $44.00 | $44.00 | 3,604 2014 Formulary | |||
2013 Humana Gold Plus SNP-DE H1951-033 (HMO SNP) | $37.30 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1951 -033 -0 | $0.00 | $0.00 | $38.00 | $38.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DE H1951-033 (HMO SNP) | $30.40 | n/a | $140 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $44.00 | $44.00 | 3,711 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H5576 -008 -0 | |||||||||||
2014 AAA4 Vantage TRADITIONAL PLUS (HMO) | $31.70 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,486 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 Peoples Health Secure Choice (HMO SNP) | $37.30 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1961 -008 -0 | 25% | 25% | 25% | 25% | 4,658 2013 Formulary | ||
2014 Peoples Health Secure Choice (HMO SNP) | $31.80 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 4,503 2014 Formulary | |||
2013 HumanaChoice R5826-078 (Regional PPO) | $42.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | R5826 -078 -0 | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-078 (Regional PPO) | $44.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,711 2014 Formulary | |||
2013 Humana Gold Choice H1906-001 (PFFS) | $49.00 | n/a | $0 | Few Generics, Few Brands |
H1906 -001 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Choice H1906-001 (PFFS) | $51.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $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 HumanaChoice R5826-011 (Regional PPO) | $72.00 | $6,700 | $0 | Few Generics, Few Brands |
R5826 -011 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-011 (Regional PPO) | $74.00 | $6,700 | $100 | Few Generics, Few Brands | $5.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Peoples Health Choices Select (HMO) | $116.00 | $6,700 | $0 | All Generics, Few Brands |
H1961 -007 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 4,658 2013 Formulary | ||
2014 Peoples Health Choices Select (HMO) | $116.00 | $6,700 | $0 | All Generics, Few Brands | $3.00 | $10.00 | $35.00 | $35.00 | 4,503 2014 Formulary | |||
2013 Today's Options Premier 600 (PFFS) | $0.00 | n/a | No Rx Coverage | H5421 -046 -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 650B (PFFS) | $46.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -070 -0 | $5.00 | $12.00 | $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) | $35.00 | n/a | No Rx Coverage | H5421 -206 -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) | $103.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -212 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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