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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2013 Martin's Point Generations Advantage Value (HMO) | $0.00 | $3,400 | No Rx Coverage | H5591 -003 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 Martin's Point Generations Advantage Value (HMO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 Martin's Point Generations Advantage Prime (HMO-POS) | $49.00 | $3,200 | $0 | No additional gap coverage, only the Donut Hole Discount | H5591 -001 -0 | $0.00 | $6.00 | $40.00 | $40.00 | 2,952 2013 Formulary | ||
2014 Martin's Point Generations Advantage Prime (HMO-POS) | $54.00 | $3,200 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $40.00 | $40.00 | 2,896 2014 Formulary | |||
2013 Martin's Point Generations Advantage Select (PPO) | $65.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | H1365 -002 -0 | $0.00 | $6.00 | $40.00 | $40.00 | 2,952 2013 Formulary | ||
2014 Martin's Point Generations Advantage Select (PPO) | $80.00 | $3,400 | $0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $40.00 | $40.00 | 2,896 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 Anthem Medicare Preferred Premier (PPO) | $95.00 | $6,000 | $100 | No additional gap coverage, only the Donut Hole Discount | H6786 -001 -0 | $5.00 | $10.00 | $39.00 | $39.00 | 2,838 2013 Formulary | ||
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2014 Anthem Medicare Preferred Premier (PPO) | $96.00 | $6,000 | $175 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $18.00 | $40.00 | $40.00 | 2,880 2014 Formulary | |||
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