ALIMTA 500MG VIAL (1 VIAL) (NDC: 00002762301)
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 |
Blue Medicare Access Standard (Regional PP
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Blue Medicare Access Value (Regional PPO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Essence Advantage (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,591.25 |
Browse Plan Formulary |
Essence Advantage (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,591.25 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,591.25 |
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 |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,591.25 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,316.18 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-119 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,709.25 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,773.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-124 (PFFS)
|
$25.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-082 (Regional PPO)
|
$33.90 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,608.49 |
Browse Plan Formulary |
WHP Silver Rx (HMO)
|
$34.10 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $2,668.89 |
Browse Plan Formulary |
HumanaChoice R5826-008 (Regional PPO)
|
$35.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-125 (PFFS)
|
$39.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $2,608.49 |
Browse Plan Formulary |
WHP Platinum Rx (HMO)
|
$42.30 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,668.89 |
Browse Plan Formulary |
Platinum Select Rx (HMO-POS)
|
$76.20 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,668.89 |
Browse Plan Formulary |