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 |
Laramie | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $4,500 | ||||||
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HumanaChoice H6609-029 (PPO) - H6609-029-0 Benefit Details |
Laramie | $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 | |||||
MedicareBlue PPO (Regional PPO) - R5566-005-0 Benefit Details |
Laramie | $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 | |||||||||
Humana Gold Choice H8145-099 (PFFS) - H8145-099-0 Benefit Details |
Laramie | $87.00 | $0 | Few Generics, Few Brands | Tier 1: $6.00 Tier 2: $39.00 Tier 3: $80.00 Tier 4: 33% | $3,400 Browse Formulary | |||||
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