2012 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Bon Homme | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Brule | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Codington | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Davison | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Edmunds | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Hanson | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
McPherson | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Spink | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Stanley | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Tripp | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Turner | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Union | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Humana Gold Choice H8145-139 (PFFS) in SD - H8145-139-0 Benefit Details |
Yankton | $59.00 | $200 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $34.00 Tier 3: $68.00 Tier 4: 28% | $5,400 Browse Formulary | |||||
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