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 Regence MedAdvantage Basic (PPO) | $64.00 | $3,400 | No Rx Coverage | H1304 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Regence MedAdvantage Basic (PPO) | $76.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Regence MedAdvantage + Rx Classic (PPO) | $98.00 | $3,400 | $165 | No additional gap coverage, only the Donut Hole Discount | H1304 -002 -0 | $7.50 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Classic (PPO) | $109.00 | $3,400 | $150 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
2013 Regence MedAdvantage + Rx Enhanced (PPO) | $188.00 | $2,500 | $0 | Many Generics | H1304 -004 -0 | $5.00 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Enhanced (PPO) | $201.00 | $2,500 | $0 | Many Generics | $5.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
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