ACTONEL WITH CALCIUM TABLET (1 (4 + 24) PKGCOM) (NDC: 00149047501)
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 |
AARP MedicareComplete (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $104.00 | Q:31 /31Days | $96.26 |
Browse Plan Formulary |
Advantra (PPO)
![Email Prescription and/or Health Benefit details for Advantra (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | S Q:28 /28Days | $96.08 |
Browse Plan Formulary |
Aetna Medicare Dual Advantage Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Dual Advantage Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:1 /1Days | $96.77 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $140.00 | Q:28 /30Days | $97.35 |
Browse Plan Formulary |
Bravo Classic Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Bravo Classic Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $140.00 | Q:28 /30Days | $97.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.40 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
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 |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.22 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.28 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H4520-005 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-005 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.78 |
Browse Plan Formulary |
Medicare Masterpiece (HMO-POS)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Medicare Masterpiece (HMO-POS)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Standard (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | S Q:28 /28Days | $99.14 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
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) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:30 /30Days | $103.67 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.39 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.87 |
Browse Plan Formulary |
Plan Name |
Monthly 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 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
Plan Name |
Monthly 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 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
Plan Name |
Monthly 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 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.28 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:31 /31Days | $96.30 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.40 |
Browse Plan Formulary |
HumanaChoice R5826-012 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-012 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.47 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.42 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-026 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-026 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Evercare Plan DH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan DH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.00 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | Q:31 /31Days | $96.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | S | $97.40 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $80.00 | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H4510-017 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H4510-017 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:28 /28Days | $95.89 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H4510-017 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H4510-017 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:28 /28Days | $95.89 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H4510-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus SNP-DE H4510-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:28 /28Days | $95.49 |
Browse Plan Formulary |
Bravo Traditions (HMO)
![Email Prescription and/or Health Benefit details for Bravo Traditions (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Traditions (HMO)
![Email Prescription and/or Health Benefit details for Bravo Traditions (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Traditions (HMO)
![Email Prescription and/or Health Benefit details for Bravo Traditions (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Bravo Traditions (HMO)
![Email Prescription and/or Health Benefit details for Bravo Traditions (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:28 /30Days | $97.41 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | S Q:28 /28Days | $99.49 |
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 |
Physicians Health Choice Select (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | S Q:28 /28Days | $99.49 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $60.00 | S Q:28 /28Days | $99.14 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $60.00 | S Q:28 /28Days | $99.14 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $60.00 | S Q:28 /28Days | $99.14 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $60.00 | S Q:28 /28Days | $99.14 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $60.00 | S Q:28 /28Days | $99.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
Humana Gold Choice H2944-024 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-024 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.60 |
Browse Plan Formulary |
HumanaChoice R5826-075 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-075 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:28 /28Days | $95.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
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 |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
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 |
Humana Gold Choice H2944-027 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-027 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:28 /28Days | $95.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | Q:1 /1Days | $96.18 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | Q:1 /1Days | $96.18 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | Q:1 /1Days | $96.77 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | Q:1 /1Days | $96.77 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | Q:1 /1Days | $96.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | Q:1 /1Days | $96.74 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | Q:1 /1Days | $96.74 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | Q:1 /1Days | $96.74 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Comfort Plus (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Comfort Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
Fidelis Secure Independence (HMO)
![Email Prescription and/or Health Benefit details for Fidelis Secure Independence (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | Q:31 /31Days | $96.25 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |
FirstCare Advantage Platinum (HMO)
![Email Prescription and/or Health Benefit details for FirstCare Advantage Platinum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | S Q:35 /35Days | $100.10 |
Browse Plan Formulary |