ACCUTANE 10MG CAPSULE (100 (10X10) BLPK) (NDC: 00004015549)
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 |
CareFree (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
CareFree (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
CareOne (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Plus H1036-047 (HMO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $1,035.13 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
|
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
|
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
|
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
|
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,119.46 |
Browse Plan Formulary |
BlueMedicare Regional PPO (Regional PPO)
|
$32.70 |
$90 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
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 |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
|
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | None | $1,080.43 |
Browse Plan Formulary |