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 Community HealthFirst MA Special Needs Plan (HMO SNP) | $37.40 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5826 -005 -0 | 25% | 3,102 2013 Formulary | |||||
2014 Community HealthFirst MA Special Needs Plan (HMO SNP) | $34.80 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 15% | 3,124 2014 Formulary | ||||||
2013 Community HealthFirst MA Pharmacy Plan (HMO) | $61.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H5826 -009 -0 | $10.00 | $50.00 | 33% | 3,102 2013 Formulary | |||
2014 Community HealthFirst MA Pharmacy Plan (HMO) | $77.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $50.00 | 33% | 3,124 2014 Formulary | ||||
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