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 |
ATRIO Tuality MyAdvantage Companion (HMO)
![Email Prescription and/or Health Benefit details for ATRIO Tuality MyAdvantage Companion (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $981.49 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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 |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,008.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$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 |
ATRIO MyAdvantage Active Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Active Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.90 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO MyAdvantage Active Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Active Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.90 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO Tuality MyAdvantage Active Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO Tuality MyAdvantage Active Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.90 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $973.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$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 H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$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 H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$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 H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$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 H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$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 H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-054 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-054 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
ATRIO MyAdvantage II Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage II Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO MyAdvantage II Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage II Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO Tuality MyAdvantage II Rx (HMO)
![Email Prescription and/or Health Benefit details for ATRIO Tuality MyAdvantage II Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.10 |
$310 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
CareSource SNP Curry County (HMO)
![Email Prescription and/or Health Benefit details for CareSource SNP Curry County (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | None | $981.49 |
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 |
Trillium Advantage (HMO)
![Email Prescription and/or Health Benefit details for Trillium Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.40 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $100.00 | None | $988.27 |
Browse Plan Formulary |
CareSource Gold Plus Rx (HMO)
![Email Prescription and/or Health Benefit details for CareSource Gold Plus Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.20 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $78.00 | None | $981.49 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
ODS Advantage PPORX (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.90 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
![Email Prescription and/or Health Benefit details for Kaiser Permanente Senior Advantage II (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$51.90 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | None | $1,000.66 |
Browse Plan Formulary |
CareSource Diamond Plus Rx (PPO)
![Email Prescription and/or Health Benefit details for CareSource Diamond Plus Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.20 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $78.00 | None | $981.49 |
Browse Plan Formulary |
CareSource Diamond Plus Rx (PPO)
![Email Prescription and/or Health Benefit details for CareSource Diamond Plus Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.20 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $78.00 | None | $981.49 |
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 |
CareSource Diamond Plus Rx (PPO)
![Email Prescription and/or Health Benefit details for CareSource Diamond Plus Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.20 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $78.00 | None | $981.49 |
Browse Plan Formulary |
CareSource Diamond Plus Rx (PPO)
![Email Prescription and/or Health Benefit details for CareSource Diamond Plus Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.20 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $78.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO MyAdvantage Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO MyAdvantage Choice Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Choice Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO Tuality MyAdvantage Choice Rx (HMO-P
![Email Prescription and/or Health Benefit details for ATRIO Tuality MyAdvantage Choice Rx (HMO-P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
2 |
Tier 2 |
$31.00 | $62.00 | None | $981.49 |
Browse Plan Formulary |
Trillium Preferred ISNP (HMO)
![Email Prescription and/or Health Benefit details for Trillium Preferred ISNP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$58.90 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $100.00 | None | $988.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Trillium Preferred ISNP (HMO)
![Email Prescription and/or Health Benefit details for Trillium Preferred ISNP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$58.90 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $100.00 | None | $988.27 |
Browse Plan Formulary |
ATRIO MyAdvantage Elite Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Elite Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO MyAdvantage Elite Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for ATRIO MyAdvantage Elite Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | None | $981.49 |
Browse Plan Formulary |
ATRIO Tuality MyAdvantage Elite Rx (HMO-PO
![Email Prescription and/or Health Benefit details for ATRIO Tuality MyAdvantage Elite Rx (HMO-PO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | None | $981.49 |
Browse Plan Formulary |
Trillium Preferred community ISNP (HMO)
![Email Prescription and/or Health Benefit details for Trillium Preferred community ISNP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.60 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $100.00 | None | $988.27 |
Browse Plan Formulary |
Trillium Preferred community ISNP (HMO)
![Email Prescription and/or Health Benefit details for Trillium Preferred community ISNP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$59.60 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $100.00 | None | $988.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
ODS Advantage PPORX Select (PPO)
![Email Prescription and/or Health Benefit details for ODS Advantage PPORX Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$86.70 |
$0 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $987.07 |
Browse Plan Formulary |