2013 / 2014 Medicare Advantage Plan Information Click here to jump to the Chart Legend | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
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 |
||||||
2013 AARP MedicareComplete (HMO) | $0.00 | $3,900 | $0 | No additional gap coverage, only the Donut Hole Discount | H3456 -001 -0 | $3.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
2014 AARP MedicareComplete (HMO) | $0.00 | $4,900 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
2013 AARP MedicareComplete Essential (HMO) | $0.00 | $3,900 | No Rx Coverage | H3456 -020 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 AARP MedicareComplete Essential (HMO) | $0.00 | $4,900 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Blue Medicare HMO Medical Only (HMO) | $0.00 | $2,500 | No Rx Coverage | H3449 -012 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Blue Medicare HMO Medical Only (HMO) | $0.00 | $2,500 | 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 |
||||||
2013 Blue Medicare HMO Standard (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H3449 -013 -0 | $7.00 | $25.00 | $40.00 | $40.00 | 3,949 2013 Formulary | ||
2014 Blue Medicare HMO Standard (HMO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $40.00 | $40.00 | 3,752 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H9725 -001 -0 | |||||||||||
new | new | new | ||||||||||
2014 Cigna-HealthSpring Preferred (HMO) | $0.00 | $3,400 | $0 | Many Generics | $3.00 | $12.00 | $45.00 | $45.00 | 2,946 2014 Formulary | |||
2013 Humana Gold Plus H1036-138 (HMO-POS) | $0.00 | $4,250 | $0 | Few Generics, Few Brands |
H1036 -138 -0 | $3.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H1036-138 (HMO) | $0.00 | $4,500 | $0 | Few Generics, Few Brands | $5.00 | $15.00 | $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 |
||||||
2013 HumanaChoice R5826-063 (Regional PPO) | $0.00 | $3,000 | No Rx Coverage | R5826 -063 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-063 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 UnitedHealthcare Dual Complete (HMO SNP) | $29.50 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H3456 -016 -0 | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | ||
2014 UnitedHealthcare Dual Complete (HMO SNP) | $16.60 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,604 2014 Formulary | |||
2013 Blue Medicare HMO Enhanced (HMO) | $16.40 | $3,400 | $0 | Some Generics, Few Brands |
H3449 -005 -0 | $4.00 | $20.00 | $30.00 | $30.00 | 3,949 2013 Formulary | ||
2014 Blue Medicare HMO Enhanced (HMO) | $18.90 | $3,400 | $0 | Some Generics | $3.00 | $6.00 | $30.00 | $30.00 | 3,752 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 Today's Options Premier 600 (PFFS) | $20.00 | n/a | No Rx Coverage | H6169 -012 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
2014 Today's Options Premier 900 (PFFS) | $22.00 | n/a | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Humana Gold Plus SNP-DE H1036-168 (HMO SNP) | $28.70 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1036 -168 -0 | $0.00 | $0.00 | $43.00 | $43.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DE H1036-168 (HMO SNP) | $23.10 | n/a | $70 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 AARP MedicareComplete Choice (PPO) | $15.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5516 -001 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
2014 AARP MedicareComplete Choice (PPO) | $25.00 | $4,500 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $45.00 | $45.00 | 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 UnitedHealthcare Nursing Home Plan (HMO SNP) | $32.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H3456 -010 -0 | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | ||
2014 UnitedHealthcare Nursing Home Plan (HMO SNP) | $28.30 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,604 2014 Formulary | |||
2013 HumanaChoice H3405-002 (PPO) | $31.00 | $4,900 | $0 | Few Generics, Few Brands |
H3405 -002 -0 | $4.00 | $15.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice H3405-002 (PPO) | $37.00 | $4,900 | $0 | Few Generics, Few Brands | $5.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Blue Medicare PPO Enhanced (PPO) | $47.20 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H3404 -001 -0 | $8.00 | $25.00 | $40.00 | $40.00 | 3,949 2013 Formulary | ||
2014 Blue Medicare PPO Enhanced (PPO) | $38.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $6.00 | $40.00 | $40.00 | 3,752 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 Choice H8145-063 (PFFS) | $47.00 | n/a | $0 | Few Generics, Few Brands |
H8145 -063 -0 | $2.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Choice H8145-063 (PFFS) | $67.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $18.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Today's Options Premier Plus 650B (PFFS) | $64.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H6169 -032 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- | ||||||||||||
2014 Today's Options Premier Plus 950B (PFFS) | $71.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 2,885 2014 Formulary | |||
2013 HumanaChoice R5826-079 (Regional PPO) | $63.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | R5826 -079 -0 | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-079 (Regional PPO) | $72.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 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 |
||||||
2013 HumanaChoice R5826-003 (Regional PPO) | $75.00 | $6,200 | $0 | Few Generics, Few Brands |
R5826 -003 -0 | $5.00 | $11.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-003 (Regional PPO) | $81.00 | $6,700 | $0 | Few Generics, Few Brands | $5.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H5378 -184 -0 | |||||||||||
2014 Today's Options Advantage Plus 950E (PPO) | $86.00 | $6,700 | $110 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 2,885 2014 Formulary | |||
2013 Blue Medicare PPO Enhanced Freedom (PPO) | $109.60 | $3,400 | $0 | Some Generics, Few Brands |
H3404 -002 -0 | $4.00 | $20.00 | $30.00 | $30.00 | 3,949 2013 Formulary | ||
2014 Blue Medicare PPO Enhanced Freedom (PPO) | $121.30 | $3,400 | $0 | Some Generics | $3.00 | $6.00 | $30.00 | $30.00 | 3,752 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 Today's Options Advantage Plus 650B (PPO) | $41.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5378 -183 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- Members will be assigned to Today's Options Advantage Plus 950E (PPO) H5378-00184 -- | ||||||||||||
2013 Today's Options Advantage Plus 350A (PPO) | $85.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5378 -199 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- Members will be assigned to Today's Options Advantage Plus 950E (PPO) H5378-00184 -- | ||||||||||||
2013 Today's Options Premier 300 (PFFS) | $50.00 | n/a | No Rx Coverage | H6169 -050 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
-- Members will be assigned to Today's Options Premier 900 (PFFS) H6169-0012 -- | ||||||||||||
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 Today's Options Premier Plus 350A (PFFS) | $117.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H6169 -054 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- | ||||||||||||
-- Members will be assigned to Today's Options Premier Plus 950B (PFFS) H6169-0032 -- | ||||||||||||
2013 Humana Gold Choice H8145-114 (PFFS) | $0.00 | n/a | No Rx Coverage | H8145 -114 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
||||||||||||
2013 Fidelis Secure Comfort (HMO SNP) | $32.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5575 -005 -0 | 25% | 25% | 25% | 25% | 3,800 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
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 Fidelis Secure Comfort Plus (HMO SNP) | $98.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5575 -006 -0 | $5.00 | $30.00 | $65.00 | $65.00 | 3,800 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
2013 Fidelis Secure Independence (HMO SNP) | $120.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5575 -007 -0 | $5.00 | $30.00 | $65.00 | $65.00 | 3,800 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
2013 Fidelis Secure Freedom (HMO SNP) | $25.50 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5575 -011 -0 | 25% | 25% | 25% | 25% | 3,800 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
|