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 AAA0 Vantage ZERO (HMO-POS) | $0.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | H5576 -007 -0 | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | ||
2014 AAA0 Vantage ZERO (HMO-POS) | $0.00 | $6,700 | $300 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $45.00 | $45.00 | 3,486 2014 Formulary | |||
2013 Humana Gold Plus H1951-025 (HMO) | $0.00 | $4,900 | $0 | Few Generics, Few Brands |
H1951 -025 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H1951-025 (HMO) | $0.00 | $5,900 | $0 | Few Generics, Few Brands | $5.00 | $12.00 | $45.00 | $45.00 | 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. | ||||||||
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 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H1903 -022 -0 | $3.00 | $35.00 | $79.00 | $79.00 | 2,835 2013 Formulary | ||
2014 WellCare Value (HMO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $35.00 | $35.00 | 2,844 2014 Formulary | |||
2013 WellCare Access (HMO SNP) | $26.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1903 -011 -0 | $0.00 | $44.00 | $95.00 | $95.00 | 2,835 2013 Formulary | ||
2014 WellCare Access (HMO SNP) | $18.50 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $3.00 | $19.00 | $19.00 | 2,844 2014 Formulary | |||
2013 Humana Gold Plus SNP-DE H1951-035 (HMO SNP) | $28.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1951 -035 -0 | $0.00 | $0.00 | $41.00 | $41.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DE H1951-035 (HMO SNP) | $20.70 | n/a | $185 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $41.00 | $41.00 | 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 AAA4 Vantage TRADITIONAL PLUS (HMO) | $37.30 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | H5576 -008 -0 | 25% | 25% | 25% | 25% | 3,768 2013 Formulary | ||
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 | |||
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 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 | |||
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 AAA1 Vantage VALUE (HMO-POS) | $51.00 | $5,900 | $325 | No additional gap coverage, only the Donut Hole Discount | H5576 -009 -0 | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | ||
2014 AAA1 Vantage VALUE (HMO-POS) | $82.00 | $5,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $45.00 | $45.00 | 3,486 2014 Formulary | |||
2013 AAA3 Vantage PREMIUM (HMO-POS) | $132.00 | $5,200 | $325 | Many Generics | H5576 -006 -0 | $5.00 | $45.00 | $85.00 | $85.00 | 3,768 2013 Formulary | ||
2014 AAA3 Vantage PREMIUM (HMO-POS) | $152.00 | $5,200 | $0 | Many Generics | $3.00 | $10.00 | $45.00 | $45.00 | 3,486 2014 Formulary | |||
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