ANTIZOL INJECTION 1GM 4 X 1.5ML VIAL CRTN (4 X 1.5 ML VIAL CRTN) (NDC: 68727020002)
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-098 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-079 (PFFS)
|
$22.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 4 |
Tier 4 |
30% | 30% | None | $6,399.47 |
Browse Plan Formulary |