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 AARP MedicareComplete SecureHorizons (HMO) | $0.00 | $3,900 | $0 | Some Generics | H4590 -012 -0 | $0.00 | $6.00 | $45.00 | $45.00 | 3,825 2013 Formulary | ||
2014 AARP MedicareComplete SecureHorizons (HMO) | $0.00 | $3,900 | $0 | Some Generics | $0.00 | $8.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
2013 AARP MedicareComplete SecureHorizons Essential (HMO) | $0.00 | $3,500 | No Rx Coverage | H4590 -027 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 AARP MedicareComplete SecureHorizons Essential (HMO) | $0.00 | $3,900 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2013 -- |
H4523 -017 -0 | |||||||||||
2014 Aetna Medicare Select Plan (HMO) | $0.00 | $3,400 | $0 | Few Generics | $10.00 | 25% | 50% | 50% | 2,800 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 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -009 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Gold Rx (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $9.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
2013 Care Improvement Plus Medicare Advantage (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -012 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Medicare Advantage (Regional PPO) | $0.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,604 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H6328 -005 -0 | |||||||||||
2014 Care N' Care Health Plan I MA-Only (PPO) | $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 |
||||||
-- This plan not offered in 2013 -- |
H6328 -003 -0 | |||||||||||
2014 Care N' Care Health Plan III (PPO) | $0.00 | $3,400 | $0 | Many Generics | $4.00 | $15.00 | $40.00 | $40.00 | 4,777 2014 Formulary | |||
2013 HealthSpring Advantage (HMO) | $0.00 | $6,700 | No Rx Coverage | H4528 -016 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Cigna-HealthSpring Advantage (HMO) | $0.00 | $6,700 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HealthSpring Advantage (PPO) | $0.00 | $3,400 | No Rx Coverage | H7787 -002 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Cigna-HealthSpring Advantage (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 |
||||||
2013 Humana Gold Plus H4510-018 (HMO) | $0.00 | $3,400 | $125 | Few Generics, Few Brands |
H4510 -018 -0 | $7.00 | $12.00 | $40.00 | $40.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Plus H4510-018 (HMO) | $0.00 | $6,700 | $125 | Few Generics, Few Brands | $7.00 | $12.00 | $40.00 | $40.00 | 3,711 2014 Formulary | |||
2013 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -026 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-026 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2013 -- |
H5656 -017 -0 | |||||||||||
2014 TexanPlus Choice (HMO-POS) | $0.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $40.00 | $40.00 | 2,885 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 TexanPlus Classic (HMO) | $0.00 | $3,400 | $0 | Many Generics, Few Brands |
H5656 -001 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
2014 TexanPlus Classic (HMO) | $0.00 | $3,400 | $0 | Some Generics, Few Brands | $2.00 | $7.00 | $40.00 | $40.00 | 2,885 2014 Formulary | |||
2013 TexanPlus Value (HMO) | $0.00 | $3,000 | No Rx Coverage | H5656 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 TexanPlus Value (HMO) | $0.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
-- This plan not offered in 2013 -- |
H8237 -001 -0 | |||||||||||
new | new | new | ||||||||||
2014 Vital Traditions (HMO) | $0.00 | $5,050 | $0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $40.00 | $40.00 | 2,878 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 |
||||||
-- This plan not offered in 2013 -- |
R5826 -091 -0 | |||||||||||
2014 HumanaChoice R5826-091 (Regional PPO) | $10.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $13.00 | $42.00 | $42.00 | 3,711 2014 Formulary | |||
2013 UnitedHealthcare Dual Complete (HMO SNP) | $22.60 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H4590 -020 -0 | 25% | 25% | 25% | 25% | 3,825 2013 Formulary | ||
2014 UnitedHealthcare Dual Complete (HMO SNP) | $12.60 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,604 2014 Formulary | |||
2013 Humana Gold Choice H8145-126 (PFFS) | $10.00 | n/a | No Rx Coverage | H8145 -126 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Humana Gold Choice H8145-126 (PFFS) | $15.00 | 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 |
||||||
2013 Care Improvement Plus Silver Rx (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R6801 -008 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Silver Rx (Regional PPO SNP) | $15.50 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,604 2014 Formulary | |||
2013 Humana Gold Plus SNP-DE H4510-023 (HMO SNP) | $31.70 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H4510 -023 -0 | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | ||
2014 Humana Gold Plus SNP-DE H4510-023 (HMO SNP) | $19.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 3,711 2014 Formulary | |||
2013 Today's Options Premier 600 (PFFS) | $0.00 | n/a | No Rx Coverage | H6169 -016 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
2014 Today's Options Premier 900 (PFFS) | $20.00 | 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 |
||||||
2013 HealthSpring Preferred (HMO) | $0.00 | $3,400 | $0 | Many Generics | H4528 -001 -0 | $0.00 | $4.00 | $35.00 | $35.00 | 3,056 2013 Formulary | ||
2014 Cigna-HealthSpring Preferred (HMO) | $22.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $8.00 | $35.00 | $35.00 | 2,946 2014 Formulary | |||
2013 HealthSpring TotalCare (HMO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H4528 -002 -0 | 25% | 3,025 2013 Formulary | |||||
2014 Cigna-HealthSpring TotalCare (HMO SNP) | $23.80 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 2,946 2014 Formulary | ||||||
2013 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R6801 -011 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
2014 Care Improvement Plus Dual Advantage (Regional PPO SNP) | $26.30 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 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 Advantage by Superior HealthPlan (HMO SNP) | $30.00 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5294 -001 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,010 2013 Formulary | ||
2014 Advantage by Superior HealthPlan (HMO SNP) | $27.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 2,966 2014 Formulary | |||
-- This plan not offered in 2013 -- |
H6328 -002 -0 | |||||||||||
2014 Care N' Care Health Plan II (PPO) | $36.00 | $3,100 | $0 | Many Generics | $0.00 | $12.00 | $36.00 | $36.00 | 4,777 2014 Formulary | |||
2013 HealthSpring Achieve (HMO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H4528 -014 -0 | $3.00 | $8.00 | $35.00 | $35.00 | 3,057 2013 Formulary | ||
2014 Cigna-HealthSpring Achieve (HMO SNP) | $47.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $8.00 | $35.00 | $35.00 | 2,946 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 R5826-012 (Regional PPO) | $59.00 | $6,700 | $125 | No additional gap coverage, only the Donut Hole Discount | R5826 -012 -0 | $7.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-012 (Regional PPO) | $65.00 | $6,700 | $0 | Few Generics, Few Brands | $7.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Humana Prime Choice H4520-006 (PPO) | $57.00 | $4,500 | $0 | Few Generics, Few Brands |
H4520 -006 -0 | $7.00 | $12.00 | $42.00 | $42.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice H4520-006 (PPO) | $66.00 | $6,600 | $0 | Few Generics, Few Brands | $7.00 | $12.00 | $42.00 | $42.00 | 3,711 2014 Formulary | |||
2013 HealthSpring Preferred (PPO) | $35.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H7787 -001 -0 | $0.00 | $4.00 | $30.00 | $30.00 | 3,056 2013 Formulary | ||
2014 Cigna-HealthSpring Preferred (PPO) | $67.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $8.00 | $35.00 | $35.00 | 2,946 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 |
||||||
-- This plan not offered in 2013 -- |
H6328 -001 -0 | |||||||||||
2014 Care N' Care Health Plan I (PPO) | $81.00 | $2,500 | $0 | Many Generics | $0.00 | $10.00 | $33.00 | $33.00 | 4,777 2014 Formulary | |||
2013 Humana Gold Choice H8145-084 (PFFS) | $87.00 | n/a | $0 | Few Generics, Few Brands |
H8145 -084 -0 | $6.00 | $12.00 | $39.00 | $39.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Choice H8145-084 (PFFS) | $89.00 | n/a | $0 | Few Generics, Few Brands | $6.00 | $12.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Today's Options Premier Plus 650B (PFFS) | $66.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H6169 -036 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- | ||||||||||||
2014 Today's Options Premier Plus 950B (PFFS) | $95.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $45.00 | $45.00 | 2,885 2014 Formulary | |||
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 Care Improvement Plus Dual Advantage (PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H0084 -005 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
-- Members will be assigned to Care Improvement Plus Dual Advantage (Regional PPO SNP) R6801-0011 -- | ||||||||||||
2013 Care Improvement Plus Silver Rx (PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H0084 -003 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
-- Members will be assigned to Care Improvement Plus Silver Rx (Regional PPO SNP) R6801-008 -- | ||||||||||||
2013 Today's Options Advantage Plus 350A (PPO) | $107.00 | $3,250 | $0 | No additional gap coverage, only the Donut Hole Discount | H5378 -010 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- Members will be assigned to Today's Options Advantage Plus 950B (PPO) H5378-0016 -- | ||||||||||||
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 300 (PFFS) | $45.00 | n/a | No Rx Coverage | H6169 -053 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- | ||||||||||||
-- Members will be assigned to Today's Options Premier 900 (PFFS) H6169-0016 -- | ||||||||||||
2013 Today's Options Premier Plus 350A (PFFS) | $122.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H6169 -057 -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) H6169-0036 -- | ||||||||||||
2013 Today's Options Advantage Plus 650B (PPO) | $32.00 | $6,700 | $0 | No additional gap coverage, only the Donut Hole Discount | H5378 -016 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 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 Care Improvement Plus Medicare Advantage (PPO) | $0.00 | $6,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H0084 -001 -0 | $6.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Care Improvement Plus Gold Rx (PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H0084 -004 -0 | $6.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Care Improvement Plus Chrome RX (PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H0084 -026 -0 | 25% | 25% | 25% | 25% | 3,401 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 Care Improvement Plus Copper RX (PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H0084 -027 -0 | $6.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
2013 Care Improvement Plus Chrome RX (Regional PPO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | R6801 -021 -0 | 25% | 25% | 25% | 25% | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
||||||||||||
2013 Care Improvement Plus Copper RX (Regional PPO SNP) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | R6801 -022 -0 | $8.00 | $45.00 | $95.00 | $95.00 | 3,401 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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