2010 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) 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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Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Aitkin | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Anoka | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Becker | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Beltrami | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Benton | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Big Stone | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Blue Earth | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Brown | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Carlton | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Carver | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Cass | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Chippewa | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Chisago | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Clay | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Clearwater | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Cook | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Cottonwood | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Crow Wing | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Dakota | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Dodge | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Douglas | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Faribault | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Fillmore | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Freeborn | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Goodhue | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Grant | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Hennepin | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Houston | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Hubbard | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Isanti | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Itasca | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Jackson | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Kanabec | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Kandiyohi | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Kittson | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Koochiching | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Lac qui Parle | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Lake | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Lake of the Woods | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Le Sueur | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Lincoln | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Lyon | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Mahnomen | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Marshall | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Martin | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
McLeod | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Meeker | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Mille Lacs | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Morrison | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Mower | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Murray | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Nicollet | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Nobles | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Norman | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Olmsted | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Otter Tail | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Pennington | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Pine | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Pipestone | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Polk | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Pope | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Ramsey | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Red Lake | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Redwood | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Renville | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Rice | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Rock | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Roseau | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Scott | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Sherburne | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Sibley | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
St. Louis | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Stearns | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Steele | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Stevens | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Swift | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Todd | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Traverse | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Wabasha | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Wadena | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Waseca | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Washington | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Watonwan | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Wilkin | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Winona | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Wright | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
Medica Prime Solution Basic w/Enhanced Rx - MN (Cost) in MN - H2450-005-0 Benefit Details |
Yellow Medicine | $141.90 | $0 | Many Generics | Generic: $10.00 Preferred Brand: $34.00 Non-Preferred Brand: $74.00 Specialty: 25% | n/a Browse Formulary | |||||
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