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 ATRIO Bronze (PPO) | $0.00 | $3,400 | No Rx Coverage | H6743 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 ATRIO Bronze (PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 ATRIO Bronze Rx (Umpqua) (PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H6743 -007 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,458 2013 Formulary | ||
2014 ATRIO Bronze Rx (Umpqua) (PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $45.00 | $45.00 | 3,267 2014 Formulary | |||
2013 CareSource Silver (HMO) | $0.00 | $3,400 | No Rx Coverage | H3810 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 CareSource Silver (HMO) | $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 Health Net Violet Option 2 (PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5520 -006 -0 | $3.00 | $20.00 | $45.00 | $45.00 | 4,263 2013 Formulary | ||
2014 Health Net Violet Option 2 (PPO) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $15.00 | $45.00 | $45.00 | 4,195 2014 Formulary | |||
2013 ATRIO Special Needs Plan (HMO SNP) | $37.50 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H3814 -007 -0 | 25% | 3,285 2013 Formulary | |||||
2014 ATRIO Special Needs Plan (HMO SNP) | $34.80 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 3,192 2014 Formulary | ||||||
2013 CareSource Bronze Rx (HMO) | $37.40 | $3,400 | $325 | No additional gap coverage, only the Donut Hole Discount | H3810 -019 -0 | 25% | 3,285 2013 Formulary | |||||
2014 CareSource Bronze Rx (HMO) | $34.80 | $3,400 | $310 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
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 ATRIO Silver (PPO) | $52.00 | $3,400 | No Rx Coverage | H6743 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 ATRIO Silver (PPO) | $49.00 | $3,200 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Health Net Aqua (PPO) | $49.00 | $2,500 | No Rx Coverage | H5520 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Health Net Aqua (PPO) | $49.00 | $2,500 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Regence MedAdvantage Basic (PPO) | $35.00 | $3,400 | No Rx Coverage | H3817 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Regence MedAdvantage Basic (PPO) | $49.00 | $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 Regence MedAdvantage + Rx Classic (PPO) | $53.00 | $3,400 | $165 | No additional gap coverage, only the Donut Hole Discount | H3817 -002 -0 | $7.50 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Classic (PPO) | $66.00 | $3,400 | $205 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
2013 ODS Advantage PPO (PPO) | $57.00 | $3,400 | No Rx Coverage | H3813 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Moda Health PPO (PPO) | $67.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 CareSource Gold (HMO) | $74.00 | $2,000 | No Rx Coverage | H3810 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 CareSource Gold (HMO) | $79.00 | $2,000 | 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 CareSource Silver Plus Rx (HMO) | $83.50 | $3,400 | $0 | Many Generics | H3810 -007 -0 | $5.00 | $29.00 | $39.00 | $39.00 | 3,458 2013 Formulary | ||
2014 CareSource Silver Plus Rx (HMO) | $80.50 | $3,400 | $0 | Few Generics | tbd | |||||||
2013 ODS Advantage PPORX (PPO) | $68.00 | $3,400 | $120 | No additional gap coverage, only the Donut Hole Discount | H3813 -006 -0 | $5.00 | $33.00 | $41.00 | $41.00 | 3,458 2013 Formulary | ||
2014 Moda Health PPORX (PPO) | $82.00 | $3,400 | $120 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $33.00 | $41.00 | $41.00 | 3,267 2014 Formulary | |||
2013 ATRIO Silver Rx (PPO) | $97.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H6743 -003 -0 | $6.00 | $40.00 | $85.00 | $85.00 | 3,458 2013 Formulary | ||
2014 ATRIO Silver Rx (PPO) | $99.00 | $3,200 | $150 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $40.00 | $40.00 | 3,267 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 Health Net Violet Option 1 (PPO) | $95.00 | $2,500 | $0 | No additional gap coverage, only the Donut Hole Discount | H5520 -004 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 4,263 2013 Formulary | ||
2014 Health Net Violet Option 1 (PPO) | $99.00 | $2,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $42.00 | $42.00 | 4,195 2014 Formulary | |||
2013 CareSource Gold Plus Rx (HMO) | $138.20 | $2,000 | $0 | Many Generics | H3810 -003 -0 | $5.00 | $29.00 | $39.00 | $39.00 | 3,458 2013 Formulary | ||
2014 CareSource Gold Plus Rx (HMO) | $148.70 | $2,000 | $0 | Few Generics | tbd | |||||||
2013 ATRIO Gold Rx (PPO) | $152.00 | $2,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H6743 -004 -0 | $4.00 | $35.00 | $75.00 | $75.00 | 3,458 2013 Formulary | ||
2014 ATRIO Gold Rx (PPO) | $157.00 | $2,500 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $35.00 | $35.00 | 3,267 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 Regence MedAdvantage + Rx Enhanced (PPO) | $143.00 | $2,500 | $0 | Many Generics | H3817 -003 -0 | $5.00 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Enhanced (PPO) | $178.00 | $2,500 | $0 | Many Generics | $5.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
2013 ATRIO Platinum Rx (PPO) | $192.00 | $1,300 | $0 | No additional gap coverage, only the Donut Hole Discount | H6743 -005 -0 | $4.00 | $35.00 | $75.00 | $75.00 | 3,458 2013 Formulary | ||
2014 ATRIO Platinum Rx (PPO) | $210.00 | $1,300 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $35.00 | $35.00 | 3,267 2014 Formulary | |||
2013 CareSource Platinum (HMO-POS) | $132.90 | $1,000 | No Rx Coverage | H3810 -004 -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 |
||||||
2013 CareSource Platinum Plus Rx (HMO-POS) | $221.90 | $1,000 | $0 | Many Generics | H3810 -005 -0 | $5.00 | $29.00 | $39.00 | $39.00 | 3,458 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Health Net Healthy Heart (PPO) | $139.00 | $2,000 | $0 | No additional gap coverage, only the Donut Hole Discount | H5520 -010 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 4,263 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 ODS Advantage PPORX Select (PPO) | $139.00 | $3,400 | $120 | No additional gap coverage, only the Donut Hole Discount | H3813 -003 -0 | $5.00 | $33.00 | $41.00 | $41.00 | 3,458 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 |
||||||
2013 CareSource - SNP (HMO SNP) | $37.40 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H3810 -002 -0 | 25% | 3,285 2013 Formulary | |||||
-- This plan not offered in 2014 -- |
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