KIONEX POW USP (454 GM BOTPL) (NDC: 00574200416)
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | None | $5,624.18 |
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
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,341.93 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,517.62 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
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
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
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
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
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
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
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
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,380.06 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
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
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
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
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,543.50 |
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
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
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
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,341.93 |
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 |
Humana Gold Choice H2944-044 (PFFS)
|
$19.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,055.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
|
$19.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,055.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
|
$19.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,055.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
|
$19.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,055.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-044 (PFFS)
|
$19.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,055.04 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
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 |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
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 |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Fidelis Secure at Home (HMO)
|
$21.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $3,030.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
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 |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
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 |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Humana Gold Choice H2944-047 (PFFS)
|
$21.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,056.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
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
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,514.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-051 (PFFS)
|
$24.60 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,178.98 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
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 |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option A (PFFS)
|
$26.00 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $4,543.91 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,380.06 |
Browse Plan Formulary |
HumanaChoice H5470-004 (PPO)
|
$27.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,086.37 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-049 (PFFS)
|
$30.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,168.09 |
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 |
HumanaChoice R5826-006 (Regional PPO)
|
$33.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $4,192.60 |
Browse Plan Formulary |
HumanaChoice R5826-072 (Regional PPO)
|
$33.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | 25% | None | $4,192.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
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 |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-046 (PFFS)
|
$34.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $4,226.65 |
Browse Plan Formulary |
Great Lakes Personal Care Plus (HMO)
|
$34.90 |
$310 | to be determined | 1 |
Tier 1 |
15% | 15% | None | $4,589.19 |
Browse Plan Formulary |
Great Lakes Personal Care Plus (HMO)
|
$34.90 |
$310 | to be determined | 1 |
Tier 1 |
15% | 15% | None | $4,589.19 |
Browse Plan Formulary |
Great Lakes Personal Care Plus (HMO)
|
$34.90 |
$310 | to be determined | 1 |
Tier 1 |
15% | 15% | None | $4,589.19 |
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
|
$38.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,517.62 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,617.46 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,571.15 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,543.91 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,597.03 |
Browse Plan Formulary |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,549.36 |
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 |
Medicare Plus Blue Option B (PFFS)
|
$40.40 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | None | $4,843.55 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
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
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
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
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
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
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,542.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
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
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,347.37 |
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
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
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
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
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
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,543.50 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
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
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
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
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | None | $4,546.23 |
Browse Plan Formulary |