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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-- This plan not offered in 2013 -- |
H8534 -001 -0 | |||||||||||
new | new | new | ||||||||||
2014 Regence BlueShield of Idaho (Medicare-Medicaid Plan) | $0.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | tbd | |||||||
2013 True Blue (HMO) | $30.00 | $3,000 | No Rx Coverage | H1350 -006 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 True Blue (HMO) | $30.00 | $3,000 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Secure Blue (PPO) | $40.00 | $3,400 | No Rx Coverage | H1302 -004 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Secure Blue (PPO) | $42.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2013 True Blue Rx Option II (HMO) | $121.00 | $3,000 | $300 | No additional gap coverage, only the Donut Hole Discount | H1350 -010 -0 | $6.00 | $31.00 | $70.00 | $70.00 | 5,002 2013 Formulary | ||
2014 True Blue Rx Option II (HMO) | $74.00 | $3,000 | $0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $31.00 | $31.00 | 4,779 2014 Formulary | |||
2013 Regence MedAdvantage Basic (PPO) | $64.00 | $3,400 | No Rx Coverage | H1304 -001 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Regence MedAdvantage Basic (PPO) | $76.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Secure Blue (PPO) | $93.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H1302 -001 -0 | $8.00 | $43.00 | $93.00 | $93.00 | 5,002 2013 Formulary | ||
2014 Secure Blue Idaho (PPO) | $98.00 | $3,400 | $200 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $7.00 | $43.00 | $43.00 | 4,779 2014 Formulary | |||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2013 Regence MedAdvantage + Rx Classic (PPO) | $98.00 | $3,400 | $165 | No additional gap coverage, only the Donut Hole Discount | H1304 -002 -0 | $7.50 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Classic (PPO) | $109.00 | $3,400 | $150 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
2013 True Blue Rx Option I (HMO) | $142.00 | $3,000 | $0 | Many Generics | H1350 -001 -0 | $6.00 | $31.00 | $70.00 | $70.00 | 5,002 2013 Formulary | ||
2014 True Blue Rx Option I (HMO) | $144.00 | $3,000 | $0 | Many Generics, Few Brands | $4.00 | $7.00 | $31.00 | $31.00 | 4,779 2014 Formulary | |||
2013 True Blue Special Needs Plan (HMO SNP) | $176.40 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H1350 -009 -0 | 25% | 25% | 25% | 25% | 5,002 2013 Formulary | ||
2014 True Blue Special Needs Plan (HMO SNP) | $184.70 | n/a | $310 | No additional gap coverage, only the Donut Hole Discount | 0% | 0% | 0% | 0% | 4,779 2014 Formulary | |||
Plan Name | Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing | Total Drugs | |||||
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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2013 Regence MedAdvantage + Rx Enhanced (PPO) | $188.00 | $2,500 | $0 | Many Generics | H1304 -004 -0 | $5.00 | $33.00 | $45.00 | $45.00 | 3,733 2013 Formulary | ||
2014 Regence MedAdvantage + Rx Enhanced (PPO) | $201.00 | $2,500 | $0 | Many Generics | $5.00 | $33.00 | $45.00 | $45.00 | 3,414 2014 Formulary | |||
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