ALDARA IMIQUIMOD CREAM 5% 24 PKT X 250 MG CRTN (24 PKT X 250 MG CRTN) (NDC: 29336061024)
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 Choice Plan 2 (Regio
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Choice Plan 2 (Regio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | $767.34 |
Browse Plan Formulary |
Advantage Choice POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Choice POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | n/a |
Browse Plan Formulary |
Advantage Plus POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plus POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | n/a |
Browse Plan Formulary |
Advantage Premium POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Premium POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | None | n/a |
Browse Plan Formulary |
Advantra Gold (HMO)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$45.00 | $135.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (HMO)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$20.00 | $40.00 | None | n/a |
Browse Plan Formulary |
CareFree (HMO)
![Email Prescription and/or Health Benefit details for CareFree (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $758.39 |
Browse Plan Formulary |
CareFree (HMO)
![Email Prescription and/or Health Benefit details for CareFree (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.91 |
Browse Plan Formulary |
CareOne (HMO)
![Email Prescription and/or Health Benefit details for CareOne (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $87.50 | Q:12 /30Days | $758.39 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Platinum Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Platinum Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $839.63 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $831.34 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
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 |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
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 |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
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 |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $823.46 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $823.46 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $823.46 |
Browse Plan Formulary |
Citrus Saver (HMO-POS)
![Email Prescription and/or Health Benefit details for Citrus Saver (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $823.46 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
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 |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
Browse Plan Formulary |
CitrusCare (HMO-POS)
![Email Prescription and/or Health Benefit details for CitrusCare (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P Q:12 /30Days | $822.40 |
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 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
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 | None | $767.82 |
Browse Plan Formulary |
Freedom Medicare Plan Rx (HMO)
![Email Prescription and/or Health Benefit details for Freedom Medicare Plan Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Freedom Medicare Plan Rx (HMO)
![Email Prescription and/or Health Benefit details for Freedom Medicare Plan Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.86 |
Browse Plan Formulary |
Freedom Savings Plan Rx (HMO)
![Email Prescription and/or Health Benefit details for Freedom Savings Plan Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.96 |
Browse Plan Formulary |
Freedom Savings Plan Rx (HMO)
![Email Prescription and/or Health Benefit details for Freedom Savings Plan Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.96 |
Browse Plan Formulary |
Freedom VIP Care (HMO)
![Email Prescription and/or Health Benefit details for Freedom VIP Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.52 |
Browse Plan Formulary |
Freedom VIP Care COPD (HMO)
![Email Prescription and/or Health Benefit details for Freedom VIP Care COPD (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.52 |
Browse Plan Formulary |
Freedom VIP Savings (HMO)
![Email Prescription and/or Health Benefit details for Freedom VIP Savings (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Freedom VIP Savings COPD (HMO)
![Email Prescription and/or Health Benefit details for Freedom VIP Savings COPD (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $120.00 | None | $771.57 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $761.89 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $761.89 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $761.89 |
Browse Plan Formulary |
Humana Gold Plus H1036-081D (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-081D (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.52 |
Browse Plan Formulary |
Humana Gold Plus H5426-008 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-008 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medica HealthCare Plans MedicareMax Direct
![Email Prescription and/or Health Benefit details for Medica HealthCare Plans MedicareMax Direct](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$20.00 | n/a | Q:12 /30Days | $797.79 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $776.52 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.61 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.65 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $776.08 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $776.08 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $776.24 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.59 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.59 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.56 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.56 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.56 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.56 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.31 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $777.28 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $777.28 |
Browse Plan Formulary |
Medicare Masterpiece (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $777.28 |
Browse Plan Formulary |
Medicare Masterpiece Premier (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$50.00 | $100.00 | None | $775.70 |
Browse Plan Formulary |
Medicare Masterpiece Premier (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$50.00 | $100.00 | None | $775.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Premier (HMO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$50.00 | $100.00 | None | $775.70 |
Browse Plan Formulary |
Molina Medicare Options Broward (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare Options Broward (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | P | $771.87 |
Browse Plan Formulary |
Molina Medicare SmartSaver (HMO)
![Email Prescription and/or Health Benefit details for Molina Medicare SmartSaver (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | P | $771.52 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $772.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $772.45 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $772.45 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $772.45 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $772.45 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Optimum Platinum Plan (HMO)
![Email Prescription and/or Health Benefit details for Optimum Platinum Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $138.00 | None | $771.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
$30.00 | $75.00 | Q:12 /15Days | $785.10 |
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 |
$30.00 | $75.00 | Q:12 /15Days | $785.10 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | None | $775.50 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | None | $775.50 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | None | $775.50 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | None | $775.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | None | $775.50 |
Browse Plan Formulary |
Preferred Care Partners Senior Health Choi
![Email Prescription and/or Health Benefit details for Preferred Care Partners Senior Health Choi](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$20.00 | $40.00 | None | $775.41 |
Browse Plan Formulary |
PUP Easy (HMO)
![Email Prescription and/or Health Benefit details for PUP Easy (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $80.00 | None | $767.94 |
Browse Plan Formulary |
PUP Rewards (HMO)
![Email Prescription and/or Health Benefit details for PUP Rewards (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $110.00 | None | $766.93 |
Browse Plan Formulary |
Summit Ideal (HMO)
![Email Prescription and/or Health Benefit details for Summit Ideal (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $90.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Summit Maximum (HMO)
![Email Prescription and/or Health Benefit details for Summit Maximum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$76.00 | $228.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Summit Maximum (HMO)
![Email Prescription and/or Health Benefit details for Summit Maximum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$76.00 | $228.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Summit Maximum (HMO)
![Email Prescription and/or Health Benefit details for Summit Maximum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$76.00 | $228.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Summit Plus (HMO)
![Email Prescription and/or Health Benefit details for Summit Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$77.00 | $231.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
VISTA Platinum Choice (HMO)
![Email Prescription and/or Health Benefit details for VISTA Platinum Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$77.00 | $231.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
VISTA Platinum Choice (HMO)
![Email Prescription and/or Health Benefit details for VISTA Platinum Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$77.00 | $231.00 | Q:12 /30Days | n/a |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $760.16 |
Browse Plan Formulary |
Universal IP (HMO)
![Email Prescription and/or Health Benefit details for Universal IP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $775.70 |
Browse Plan Formulary |
Universal IP (HMO)
![Email Prescription and/or Health Benefit details for Universal IP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $775.70 |
Browse Plan Formulary |
Universal IP (HMO)
![Email Prescription and/or Health Benefit details for Universal IP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $775.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.28 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.35 |
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 | None | $776.35 |
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 | None | $776.35 |
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 | None | $776.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
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 |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
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 |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
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 |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
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 |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | None | $779.67 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.52 |
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 | None | $776.62 |
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 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 | None | $776.62 |
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 |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.30 |
$0 |
to be determined |
3 |
Tier 3 |
$37.00 | $74.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.30 |
$0 |
to be determined |
3 |
Tier 3 |
$37.00 | $74.00 | None | $768.46 |
Browse Plan Formulary |
Evercare Plan RDP (Regional PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan RDP (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.34 |
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) |
$19.70 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | Q:12 /15Days | $785.10 |
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) |
$19.70 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | Q:12 /15Days | $785.10 |
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) |
$19.90 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.53 |
Browse Plan Formulary |
Plan Name |
Monthly 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 DH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan DH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.53 |
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) |
$19.90 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.53 |
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) |
$19.90 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.53 |
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) |
$19.90 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $767.53 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $787.95 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $768.66 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $768.66 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $768.66 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $768.66 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
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 |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
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 |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.74 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | None | $822.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $787.95 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.62 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $783.03 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $787.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $787.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | None | $787.12 |
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 | None | $776.35 |
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 | None | $776.35 |
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 | None | $776.35 |
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 |
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 | None | $776.35 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-139 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-139 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.60 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | Q:12 /30Days | $756.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.82 |
Browse Plan Formulary |
HumanaChoice R5826-074 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-074 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:12 /30Days | $759.87 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.59 |
Browse Plan Formulary |
Medicare Masterpiece (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.59 |
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) |
$30.30 |
$0 |
to be determined |
3 |
Tier 3 |
$37.00 | $74.00 | None | $768.46 |
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) |
$30.30 |
$0 |
to be determined |
3 |
Tier 3 |
$37.00 | $74.00 | None | $768.46 |
Browse Plan Formulary |
BlueMedicare Regional PPO (Regional PPO)
![Email Prescription and/or Health Benefit details for BlueMedicare Regional PPO (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.70 |
$90 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (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:12 /30Days | $759.90 |
Browse Plan Formulary |
HumanaChoice R5826-005 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-005 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:12 /30Days | $759.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | None | $768.46 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.86 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece Premier (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece Premier (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $775.88 |
Browse Plan Formulary |
Humana Gold Choice H2944-143 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-143 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.40 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $756.41 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $767.74 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $767.74 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $105.00 | None | $774.70 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $105.00 | None | $774.70 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | n/a |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $782.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | n/a |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $765.76 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $765.76 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $765.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.28 |
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 |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $150.00 | Q:12 /30Days | $759.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - COPD (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - COPD (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
3 |
Tier 3 |
$95.00 | $190.00 | P Q:12 /30Days | $767.25 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $780.14 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Diabetes (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Diabetes (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
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 |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
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 |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
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 |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
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 |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$53.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $779.67 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.40 |
$0 |
to be determined |
3 |
Tier 3 |
$45.00 | $90.00 | None | $765.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.40 |
$0 |
to be determined |
3 |
Tier 3 |
$45.00 | $90.00 | None | $765.76 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.40 |
$0 |
to be determined |
3 |
Tier 3 |
$45.00 | $90.00 | None | $765.76 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |
Medicare Masterpiece SNP - Dementia (PPO)
![Email Prescription and/or Health Benefit details for Medicare Masterpiece SNP - Dementia (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$63.10 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $775.88 |
Browse Plan Formulary |