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 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | R5826 -068 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
2014 HumanaChoice R5826-068 (Regional PPO) | $0.00 | $3,400 | No Rx Coverage | This plan does NOT include Prescription Drug coverage. | ||||||||
2013 HumanaChoice R5826-078 (Regional PPO) | $42.00 | $6,700 | $325 | No additional gap coverage, only the Donut Hole Discount | R5826 -078 -0 | 25% | 25% | 25% | 25% | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-078 (Regional PPO) | $44.00 | $6,700 | $310 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,711 2014 Formulary | |||
2013 HumanaChoice R5826-011 (Regional PPO) | $72.00 | $6,700 | $0 | Few Generics, Few Brands |
R5826 -011 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 HumanaChoice R5826-011 (Regional PPO) | $74.00 | $6,700 | $100 | Few Generics, Few Brands | $5.00 | $12.00 | $45.00 | $45.00 | 3,711 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 Humana Gold Choice H2944-085 (PFFS) | $81.00 | n/a | $0 | Few Generics, Few Brands |
H2944 -085 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,906 2013 Formulary | ||
2014 Humana Gold Choice H2944-085 (PFFS) | $122.00 | n/a | $200 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $45.00 | $45.00 | 3,711 2014 Formulary | |||
2013 Windsor Medicare Extra Emerald Plan (HMO) | $0.00 | $6,700 | $0 | Some Generics | H5698 -061 -0 | $3.00 | $10.00 | $44.00 | $44.00 | 2,715 2013 Formulary | ||
-- Members will be assigned to Windsor Medicare Extra Gold Plan (HMO) H5698-0028 -- | ||||||||||||
2013 Today's Options Premier Plus 350A (PFFS) | $144.00 | n/a | $0 | No additional gap coverage, only the Donut Hole Discount | H5421 -067 -0 | $2.00 | $7.00 | $40.00 | $40.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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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 Today's Options Premier 600 (PFFS) | $60.00 | n/a | No Rx Coverage | H5421 -049 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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2013 Today's Options Premier Plus 650H (PFFS) | $87.00 | n/a | $87 | No additional gap coverage, only the Donut Hole Discount | H5421 -073 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 4,885 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Today's Options Premier 300 (PFFS) | $95.00 | n/a | No Rx Coverage | H5421 -209 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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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 Windsor Medicare Extra Gold Plan (HMO) | $35.00 | $3,400 | $0 | Some Generics | H5698 -028 -0 | $3.00 | $10.00 | $43.00 | $43.00 | 2,715 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Windsor Medicare Extra Silver Plan (HMO) | $0.00 | $3,400 | No Rx Coverage | H5698 -035 -0 | This plan does NOT include Prescription Drug coverage. | |||||||
-- This plan not offered in 2014 -- |
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2013 Windsor Medicare Extra Diamond Plan (HMO) | $113.00 | $4,500 | $0 | Some Generics | H5698 -067 -0 | $3.00 | $10.00 | $40.00 | $40.00 | 2,715 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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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 Windsor Medicare Extra Comp Plus Plan (HMO SNP) | $31.80 | n/a | $325 | No additional gap coverage, only the Donut Hole Discount | H5698 -134 -0 | 25% | 25% | 25% | 25% | 2,715 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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2013 Windsor Medicare Extra Diabetes Plan (HMO SNP) | $128.00 | n/a | $0 | Some Generics | H5698 -155 -0 | $4.00 | $10.00 | $40.00 | $40.00 | 2,715 2013 Formulary | ||
-- This plan not offered in 2014 -- |
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