2013 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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HumanaChoice R5826-063 (Regional PPO) - R5826-063-0 Benefit Details |
Sussex | $0.00 | No Rx Coverage | This Plan does NOT include Prescription Drug coverage. | $3,000 | ||||||
HumanaChoice H2542-001 (PPO) - H2542-001-0 Benefit Details |
Sussex | $39.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $4,900 Browse Formulary | |||||
HumanaChoice R5826-079 (Regional PPO) - R5826-079-0 Benefit Details |
Sussex | $63.00 | $325 | No additional gap coverage, only the Donut Hole Discount | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% | $6,700 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 | |||||||||
HumanaChoice R5826-003 (Regional PPO) - R5826-003-0 Benefit Details |
Sussex | $75.00 | $0 | Few Generics, Few Brands | Preferred Generic: $5.00 Non-Preferred Generic: $11.00 Preferred Brand: $45.00 Non-Preferred Brand: $90.00 Specialty Tier: 33% | $6,200 Browse Formulary | |||||
Humana Reader's Digest Healthy Living Plan (PPO) - H2542-005-0 Benefit Details |
Sussex | $139.00 | $0 | Few Generics, Few Brands | Preferred Generic: $6.00 Non-Preferred Generic: $15.00 Preferred Brand: $45.00 Non-Preferred Brand: $95.00 Specialty Tier: 33% | $5,000 Browse Formulary | |||||
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