ABRAXANE 100MG VIAL (1 X 100 MG VIALSD) (NDC: 68817013450)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
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 |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
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 | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $936.67 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $969.49 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
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 |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
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 |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-098 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-079 (PFFS)
|
$22.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $985.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
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 |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Evercare Plan IH-POS (HMO-POS)
|
$34.20 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $1,008.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
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 |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
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 |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $973.73 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
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 |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $970.22 |
Browse Plan Formulary |