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 H8145-097 (PFFS) - H8145-097-0 Benefit Details |
Cascade | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
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New West Medicare (PPO) - H2701-003-0 Benefit Details |
Cascade | $16.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $4.00 Tier 2: $40.00 Tier 3: $80.00 Tier 4: 33% | $5,000 Browse Formulary | |||||
WindsorSterling Emerald Connect Plan (PFFS) - H3410-004-13 Benefit Details |
Cascade | $28.50 | $150 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $10.00 Tier 3: $33.00 Tier 4: $87.00 Tier 5: 29% | $6,700 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 | |||||||||
WindsorSterling Silver Connect Plan (PFFS) - H3410-002-13 Benefit Details |
Cascade | $30.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,000 | ||||||
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HumanaChoice H6609-029 (PPO) - H6609-029-0 Benefit Details |
Cascade | $57.00 | $0 | Few Generics, Few Brands | Tier 1: $5.00 Tier 2: $35.00 Tier 3: $80.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
WindsorSterling Gold Connect Plan (PFFS) - H3410-003-13 Benefit Details |
Cascade | $59.00 | $50 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $15.00 Tier 3: $34.00 Tier 4: $84.00 Tier 5: 30% | $4,000 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 | |||||||||
WindsorSterling Gold Plus Plan (PPO) - H8558-002-0 Benefit Details |
Cascade | $60.00 | $0 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $5.00 Tier 2: $16.00 Tier 3: $36.00 Tier 4: $90.00 Tier 5: 30% | $4,000 Browse Formulary | |||||
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Humana Gold Choice H8145-095 (PFFS) - H8145-095-0 Benefit Details |
Cascade | $62.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $38.00 Tier 3: $80.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
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MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Cascade | $84.40 | $155 | No additional gap coverage, only the Donut Hole Discount | Tier 1: $6.00 Tier 2: $11.00 Tier 3: $33.00 Tier 4: 45% | $3,400 Browse Formulary | |||||
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 | |||||||||
New West Medicare Enhanced (PPO) - H2701-001-0 Benefit Details |
Cascade | $89.00 | $0 | Many Generics | Tier 1: $10.00 Tier 2: $35.00 Tier 3: $70.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
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