ALINIA 500MG TABLET (60 BOT) (NDC: 67546011111)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
Northeast Community Care - Plus (HMO)
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $1,182.08 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,195.66 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,195.66 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,270.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,270.63 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,259.41 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
$68.00 | $136.00 | None | $1,206.54 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
$68.00 | $136.00 | None | $1,206.54 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,196.74 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,196.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,209.53 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,209.53 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,209.53 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,209.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,200.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,238.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,199.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,198.99 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$11.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,198.99 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,198.99 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,198.99 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,238.29 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,209.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,210.06 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,246.99 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,246.99 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom - Drug (PFFS)
|
$17.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,246.99 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.77 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Martin's Point Generations Advantage Selec
|
$20.60 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:12 /25Days | $1,189.32 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom - Drug (PFFS)
|
$21.10 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $1,221.38 |
Browse Plan Formulary |
Martin's Point Generations Advantage Prime
|
$21.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | Q:12 /25Days | $1,189.32 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,231.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,180.76 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $1,188.80 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,199.08 |
Browse Plan Formulary |
Northeast Community Care - Dual Plus (HMO)
|
$27.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care - Enhanced (HMO)
|
$27.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care- Plus (HMO)
|
$27.40 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care- Plus (HMO)
|
$27.40 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Northeast Community Care- Plus (HMO)
|
$27.40 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | Q:12 /25Days | $1,189.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$32.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,202.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,200.40 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,246.99 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,246.99 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,246.99 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
First Seniority Freedom Plus - Drug (PFFS)
|
$60.30 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | None | $1,221.38 |
Browse Plan Formulary |