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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Today's Options Value powered by CCRx (PFFS) in AZ - H5421-074-0 Benefit Details |
La Paz | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in AZ - H5421-074-0 Benefit Details |
Yuma | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in AR - H5421-074-0 Benefit Details |
Calhoun | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in AR - H5421-074-0 Benefit Details |
Chicot | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in AR - H5421-074-0 Benefit Details |
Saline | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in AR - H5421-074-0 Benefit Details |
Sevier | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Glenn | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Monterey | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Plumas | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Tehama | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Trinity | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in CA - H5421-074-0 Benefit Details |
Tuolumne | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in CO - H5421-074-0 Benefit Details |
Baca | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in FL - H5421-074-0 Benefit Details |
Gulf | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in FL - H5421-074-0 Benefit Details |
Jackson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in FL - H5421-074-0 Benefit Details |
Lafayette | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Appling | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Atkinson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Brantley | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Brooks | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Clinch | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Echols | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Glascock | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Jefferson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Johnson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Lowndes | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Monroe | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Montgomery | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Putnam | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Seminole | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in GA - H5421-074-0 Benefit Details |
Toombs | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in ID - H5421-074-0 Benefit Details |
Butte | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in ID - H5421-074-0 Benefit Details |
Camas | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Alexander | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Bond | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Franklin | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Greene | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Jackson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Jefferson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Kankakee | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Marion | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Shelby | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
Wayne | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IL - H5421-074-0 Benefit Details |
White | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IN - H5421-074-0 Benefit Details |
Jennings | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IN - H5421-074-0 Benefit Details |
La Porte | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IN - H5421-074-0 Benefit Details |
Pike | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IN - H5421-074-0 Benefit Details |
Rush | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in IA - H5421-074-0 Benefit Details |
Adams | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IA - H5421-074-0 Benefit Details |
Pocahontas | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in IA - H5421-074-0 Benefit Details |
Sac | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Cheyenne | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Comanche | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Ellsworth | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Ford | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Gray | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Hamilton | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Lincoln | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Marion | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Morton | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Phillips | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Rawlins | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Rooks | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Rush | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Russell | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Seward | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Thomas | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Wilson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KS - H5421-074-0 Benefit Details |
Woodson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KY - H5421-074-0 Benefit Details |
Allen | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KY - H5421-074-0 Benefit Details |
Carlisle | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KY - H5421-074-0 Benefit Details |
Grayson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in KY - H5421-074-0 Benefit Details |
Hart | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in KY - H5421-074-0 Benefit Details |
Simpson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in LA - H5421-074-0 Benefit Details |
Lafayette | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in LA - H5421-074-0 Benefit Details |
St. Martin | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Alcona | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Alger | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Alpena | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Charlevoix | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Cheboygan | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Chippewa | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Delta | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Houghton | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Iron | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Lake | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Mackinac | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Ontonagon | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MI - H5421-074-0 Benefit Details |
Schoolcraft | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MS - H5421-074-0 Benefit Details |
Harrison | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MS - H5421-074-0 Benefit Details |
Itawamba | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MS - H5421-074-0 Benefit Details |
Lee | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MS - H5421-074-0 Benefit Details |
Union | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MO - H5421-074-0 Benefit Details |
Grundy | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MO - H5421-074-0 Benefit Details |
Holt | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MO - H5421-074-0 Benefit Details |
Lewis | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MO - H5421-074-0 Benefit Details |
Mercer | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MO - H5421-074-0 Benefit Details |
Worth | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MT - H5421-074-0 Benefit Details |
Deer Lodge | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MT - H5421-074-0 Benefit Details |
Liberty | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MT - H5421-074-0 Benefit Details |
Madison | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in MT - H5421-074-0 Benefit Details |
Teton | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in MT - H5421-074-0 Benefit Details |
Valley | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Arthur | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Chase | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Cherry | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Clay | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Fillmore | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Franklin | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Frontier | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Garden | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Harlan | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Hitchcock | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Howard | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Johnson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Kimball | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Nemaha | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Pawnee | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Pierce | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Polk | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Red Willow | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Saline | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Sherman | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Thayer | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Valley | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NE - H5421-074-0 Benefit Details |
Washington | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NC - H5421-074-0 Benefit Details |
Craven | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NC - H5421-074-0 Benefit Details |
Dare | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NC - H5421-074-0 Benefit Details |
Nash | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in NC - H5421-074-0 Benefit Details |
Sampson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in NC - H5421-074-0 Benefit Details |
Wayne | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in ND - H5421-074-0 Benefit Details |
Bowman | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in ND - H5421-074-0 Benefit Details |
Nelson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Custer | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Grady | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Grant | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Harper | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Kiowa | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Major | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Okmulgee | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OK - H5421-074-0 Benefit Details |
Woodward | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in OR - H5421-074-0 Benefit Details |
Josephine | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OR - H5421-074-0 Benefit Details |
Lane | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in OR - H5421-074-0 Benefit Details |
Tillamook | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in OR - H5421-074-0 Benefit Details |
Yamhill | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in SC - H5421-074-0 Benefit Details |
Chester | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in SC - H5421-074-0 Benefit Details |
Horry | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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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Today's Options Value powered by CCRx (PFFS) in SC - H5421-074-0 Benefit Details |
Orangeburg | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in SC - H5421-074-0 Benefit Details |
Union | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Caldwell | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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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Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Cherokee | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Comal | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Cottle | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Dallam | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Ector | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Erath | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Foard | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Garza | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Goliad | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Jackson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
King | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Lubbock | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Motley | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Pecos | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Real | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Scurry | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Shelby | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Stonewall | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Taylor | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Trinity | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Victoria | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Wharton | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in TX - H5421-074-0 Benefit Details |
Young | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in VA - H5421-074-0 Benefit Details |
Bath | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in VA - H5421-074-0 Benefit Details |
Dickenson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in VA - H5421-074-0 Benefit Details |
Tazewell | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in VA - H5421-074-0 Benefit Details |
Wise | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | 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 | |||||||||
Today's Options Value powered by CCRx (PFFS) in WA - H5421-074-0 Benefit Details |
Jefferson | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
Today's Options Value powered by CCRx (PFFS) in WI - H5421-074-0 Benefit Details |
Walworth | $68.00 | $0 | No Gap Coverage | Generic: $5.00 Preferred Brand: $35.00 Non-Preferred Brand: $65.00 Specialty: 33% | n/a Browse Formulary | |||||
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