ANDROGEL 1%(50MG) GEL PACKET (3O X 5GM PKT CRTN) (NDC: 00051845030)
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 | P | $259.86 |
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 |
2 |
Tier 2 |
$5.00 | $10.00 | P | $260.44 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$20.00 | $40.00 | P | $260.11 |
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 |
3 |
Tier 3 |
$5.00 | $10.00 | P | $251.12 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.99 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.98 |
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 |
2 |
Tier 2 |
$0.00 | $0.00 | Q:300 /30Days | $256.99 |
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 | P | $259.86 |
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 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 | P | $259.86 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.43 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.43 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
Browse Plan Formulary |
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 | None | $270.02 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.65 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.73 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.65 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.74 |
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 (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.68 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.68 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.68 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.68 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.65 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.74 |
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 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 |
3 |
Tier 3 |
$20.00 | $40.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$20.00 | $40.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$20.00 | $40.00 | P | $262.74 |
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 |
3 |
Tier 3 |
$70.00 | $195.00 | Q:300 /30Days | $255.38 |
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 |
3 |
Tier 3 |
$70.00 | $195.00 | Q:300 /30Days | $255.38 |
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 | $262.48 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $262.48 |
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 | $262.48 |
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 | $262.48 |
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 | $262.48 |
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 | $262.53 |
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 | P | $259.97 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 | P | $259.79 |
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 |
2 |
Tier 2 |
$0.00 | $0.00 | P | $260.17 |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.20 |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.20 |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.20 |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.23 |
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 |
2 |
Tier 2 |
$40.00 | $80.00 | P | $260.23 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
3 |
Tier 3 |
25% | 25% | P | $262.74 |
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 |
3 |
Tier 3 |
25% | 25% | P | $262.74 |
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 |
3 |
Tier 3 |
25% | 25% | P | $262.74 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.96 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.77 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.77 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.77 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.96 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.92 |
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 | $259.37 |
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 | $259.37 |
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% | P | $259.86 |
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 |
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 |
3 |
Tier 3 |
$70.00 | $195.00 | Q:300 /30Days | $255.38 |
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 |
3 |
Tier 3 |
$70.00 | $195.00 | Q:300 /30Days | $255.38 |
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% | P | $259.76 |
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% | P | $259.76 |
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% | P | $259.76 |
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% | P | $259.76 |
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 |
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% | P | $259.76 |
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 | $266.34 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.70 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.70 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.70 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.70 |
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 (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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 (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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:300 /30Days | $279.15 |
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 | P Q:300 /30Days | $279.15 |
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 | $266.34 |
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 | $263.92 |
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 | $263.92 |
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 | $263.92 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $263.92 |
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 | $263.92 |
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 | $263.92 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $264.85 |
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 | $264.85 |
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 | $264.85 |
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 | $267.04 |
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 | $267.04 |
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 | $267.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.77 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.77 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.77 |
Browse Plan Formulary |
Any, Any, Any Platinum (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 |
3 |
Tier 3 |
$30.00 | $60.00 | P | $262.77 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.38 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.40 |
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 |
2 |
Tier 2 |
25% | 25% | Q:300 /30Days | $257.35 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.71 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.71 |
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 | $259.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.30 |
$0 |
to be determined |
3 |
Tier 3 |
$37.00 | $74.00 | None | $259.37 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$38.00 | $95.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$42.00 | $105.00 | Q:300 /30Days | $257.35 |
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 | $259.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
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 | $259.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $259.37 |
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 | $259.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $256.81 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 (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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.38 |
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 | $260.17 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$39.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $260.17 |
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 | $253.34 |
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 | $253.34 |
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 | $258.86 |
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 | $258.86 |
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 | $258.86 |
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 H2944-144 (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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
2 |
Tier 2 |
$40.00 | $100.00 | Q:300 /30Days | $257.37 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
2 |
Tier 2 |
$45.00 | $90.00 | None | $259.61 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
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 | $258.86 |
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 | $258.86 |
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 | $258.86 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
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 |
3 |
Tier 3 |
$35.00 | $70.00 | P | $262.70 |
Browse Plan Formulary |