2010 Medicare Part D Contract ID/Plan ID Search
This is archive material for research purposes. Please see
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MAFinder.com for current plans.
Enter a Contract ID and Plan ID
| 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 AL - H5421-174-0 Benefit Details 
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Cherokee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Chilton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Clarke | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Clay | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Cleburne | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Coosa | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Cullman | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Dale | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Dallas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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DeKalb | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Escambia | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Etowah | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Geneva | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Greene | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Hale | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Jackson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Jefferson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Lamar | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Limestone | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Marengo | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Marion | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Marshall | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Monroe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Pickens | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 AL - H5421-174-0 Benefit Details
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St. Clair | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Talladega | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Walker | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Washington | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AL - H5421-174-0 Benefit Details
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Winston | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AZ - H5421-174-0 Benefit Details
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Gila | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Baxter | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Clark | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Columbia | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Conway | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Cross | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Dallas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Greene | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Hempstead | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Independence | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Izard | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Lawrence | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Mississippi | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Monroe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Nevada | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Pike | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Poinsett | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Sharp | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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St. Francis | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Stone | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Union | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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White | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in AR - H5421-174-0 Benefit Details
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Yell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CA - H5421-174-0 Benefit Details
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Marin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CA - H5421-174-0 Benefit Details
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Orange | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CA - H5421-174-0 Benefit Details
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San Luis Obispo | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CA - H5421-174-0 Benefit Details
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San Mateo | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CA - H5421-174-0 Benefit Details
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Stanislaus | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Garfield | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Gilpin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Jackson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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La Plata | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Mineral | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Montrose | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Phillips | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Rio Grande | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in CO - H5421-174-0 Benefit Details
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Sedgwick | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
|
Clay | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Collier | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Columbia | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Deduct- ible |
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
|
DeSoto | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Duval | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Gilchrist | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
|
Holmes | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Manatee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Nassau | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
|
Okeechobee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Pasco | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Pinellas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 FL - H5421-174-0 Benefit Details
|
Sarasota | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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St. Lucie | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in FL - H5421-174-0 Benefit Details
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Union | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 GA - H5421-174-0 Benefit Details
|
Bryan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Bulloch | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
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Calhoun | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Charlton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
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Cherokee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
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Floyd | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 GA - H5421-174-0 Benefit Details
|
Miller | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Mitchell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Pulaski | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Rabun | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
|
Taylor | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in GA - H5421-174-0 Benefit Details
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Worth | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 ID - H5421-174-0 Benefit Details
|
Bonneville | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Fremont | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Gooding | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Jefferson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Kootenai | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Madison | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Nez Perce | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ID - H5421-174-0 Benefit Details
|
Teton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Cumberland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 IL - H5421-174-0 Benefit Details
|
Fulton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Hardin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Henderson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 IL - H5421-174-0 Benefit Details
|
Jersey | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Kane | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
La Salle | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 IL - H5421-174-0 Benefit Details
|
Lawrence | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Livingston | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Logan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 IL - H5421-174-0 Benefit Details
|
Mason | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
McHenry | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Montgomery | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 IL - H5421-174-0 Benefit Details
|
Putnam | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Randolph | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IL - H5421-174-0 Benefit Details
|
Wabash | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 | |||||||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Benton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Carroll | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Clay | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 | |||||||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Clinton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Crawford | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Daviess | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 | |||||||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Knox | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Miami | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Switzerland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
| Service | Exper. | Cost Info | |||||||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Tippecanoe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Vermillion | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IN - H5421-174-0 Benefit Details
|
Warren | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 IA - H5421-174-0 Benefit Details
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Buchanan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
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Butler | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
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Chickasaw | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
|
Clayton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
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Des Moines | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
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Monona | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in IA - H5421-174-0 Benefit Details
|
Shelby | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KS - H5421-174-0 Benefit Details
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Allen | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KS - H5421-174-0 Benefit Details
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Cherokee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KS - H5421-174-0 Benefit Details
|
Osage | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KS - H5421-174-0 Benefit Details
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Pottawatomie | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KS - H5421-174-0 Benefit Details
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Shawnee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Anderson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Ballard | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Boyd | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Boyle | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Bracken | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Breckinridge | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Caldwell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Calloway | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Fleming | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Franklin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Green | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Hancock | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Hardin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Harlan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Hickman | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Johnson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Knox | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Laurel | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Lewis | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Lyon | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
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Magoffin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Marshall | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Martin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Mason | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
McCracken | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Monroe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Nicholas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Owsley | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Pulaski | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Russell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Spencer | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Taylor | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Union | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in KY - H5421-174-0 Benefit Details
|
Whitley | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Beauregard | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Bienville | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Concordia | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Franklin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Ouachita | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Red River | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Richland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
St. Helena | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
St. Landry | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
St. Tammany | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Tangipahoa | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Vermilion | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
Webster | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in LA - H5421-174-0 Benefit Details
|
West Carroll | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 LA - H5421-174-0 Benefit Details
|
West Feliciana | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
|
Antrim | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
|
Bay | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| Plan Name | County | Monthly Prem. |
Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
| Service | Exper. | Cost Info | |||||||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
|
Benzie | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
|
Crawford | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Gladwin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Hillsdale | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Isabella | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Jackson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Leelanau | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Manistee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Oceana | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Sanilac | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Shiawassee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MI - H5421-174-0 Benefit Details
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Washtenaw | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Carver | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Chisago | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Crow Wing | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Dodge | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Kanabec | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Lake of the Woods | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Mahnomen | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Marshall | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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McLeod | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Mille Lacs | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Mower | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Murray | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Norman | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Ramsey | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Traverse | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MN - H5421-174-0 Benefit Details
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Yellow Medicine | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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DeSoto | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Greene | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Jasper | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Newton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Sharkey | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Simpson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Smith | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Tallahatchie | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Tishomingo | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Walthall | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Wayne | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MS - H5421-174-0 Benefit Details
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Webster | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Bates | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Camden | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Chariton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Dunklin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Howard | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Macon | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Maries | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Mississippi | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Morgan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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New Madrid | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Newton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Phelps | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Pike | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Pulaski | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Ray | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Shelby | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MO - H5421-174-0 Benefit Details
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Taney | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MT - H5421-174-0 Benefit Details
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Big Horn | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MT - H5421-174-0 Benefit Details
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Cascade | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in MT - H5421-174-0 Benefit Details
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Park | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NE - H5421-174-0 Benefit Details
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Colfax | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NE - H5421-174-0 Benefit Details
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Otoe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Elko | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Humboldt | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Lincoln | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Lyon | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Mineral | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NV - H5421-174-0 Benefit Details
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Storey | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Avery | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Carteret | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Edgecombe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Hertford | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Onslow | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Pitt | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Stanly | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Swain | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Wilkes | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in NC - H5421-174-0 Benefit Details
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Wilson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ND - H5421-174-0 Benefit Details
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Pierce | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in ND - H5421-174-0 Benefit Details
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Sargent | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Adams | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Auglaize | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Clinton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Darke | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Erie | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Fairfield | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Hardin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Henry | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Highland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Hocking | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Huron | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Lorain | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Lucas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Mercer | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Monroe | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Putnam | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Richland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Ross | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Van Wert | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Vinton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OH - H5421-174-0 Benefit Details
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Washington | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Cherokee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Garfield | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Haskell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Latimer | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Love | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Murray | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OK - H5421-174-0 Benefit Details
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Pawnee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in OR - H5421-174-0 Benefit Details
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Wheeler | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in SC - H5421-174-0 Benefit Details
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Chesterfield | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in SC - H5421-174-0 Benefit Details
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Marlboro | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in SC - H5421-174-0 Benefit Details
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Oconee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Bedford | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Benton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Campbell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Carroll | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Cheatham | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Claiborne | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Dyer | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Fayette | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Fentress | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Hancock | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Hardeman | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Haywood | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Humphreys | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Jefferson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Marshall | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Moore | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Shelby | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Smith | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Sumner | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Tipton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TN - H5421-174-0 Benefit Details
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Trousdale | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Andrews | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Armstrong | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Bastrop | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Bosque | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Cochran | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Comanche | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Crosby | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Dawson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Fannin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Gaines | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Hidalgo | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Hill | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Hutchinson | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Karnes | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Lavaca | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Lee | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Matagorda | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Moore | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Panola | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Polk | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Reagan | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Refugio | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Sabine | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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San Saba | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Somervell | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Sutton | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Swisher | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in TX - H5421-174-0 Benefit Details
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Travis | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in UT - H5421-174-0 Benefit Details
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Carbon | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in UT - H5421-174-0 Benefit Details
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Washington | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Accomack | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Albemarle | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Alexandria City | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Buckingham | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Charlottesville City | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Essex | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Falls Church City | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Manassas Park City | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Norton City | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Orange | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in VA - H5421-174-0 Benefit Details
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Westmoreland | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
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MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Adams | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Asotin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Columbia | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Douglas | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Ferry | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Franklin | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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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 WA - H5421-174-0 Benefit Details
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Grant | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Grays Harbor | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Lewis | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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| 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 | |||||||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Pend Oreille | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Skagit | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WA - H5421-174-0 Benefit Details
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Whitman | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Deduct- ible |
Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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| Service | Exper. | Cost Info | |||||||||
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Today's Options Value powered by CCRx (PFFS) in WI - H5421-174-0 Benefit Details
|
Clark | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WI - H5421-174-0 Benefit Details
|
Grant | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Today's Options Value powered by CCRx (PFFS) in WI - H5421-174-0 Benefit Details
|
Lafayette | $99.00 | $310 | No Gap Coverage | Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% | n/a Browse Formulary | |||||
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Chart Legend:
Below are a few notes to help with the understanding of the 2010 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.
Below are a few notes to help with the understanding of the 2010 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.
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