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 |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$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 H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-019 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-019 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
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)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | 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 H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$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 H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$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 H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-020 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-020 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Medica Prime Solution Value (Cost)
![Email Prescription and/or Health Benefit details for Medica Prime Solution Value (Cost)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$55 |
to be determined |
3 |
Tier 3 |
$74.00 | $148.00 | None | $6,513.96 |
Browse Plan Formulary |
Medica Prime Solution Basic w/Standard Rx
![Email Prescription and/or Health Benefit details for Medica Prime Solution Basic w/Standard Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$0 |
to be determined |
3 |
Tier 3 |
$74.00 | $148.00 | None | $6,513.96 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medica Prime Solution Enhanced w/Std Rx -
![Email Prescription and/or Health Benefit details for Medica Prime Solution Enhanced w/Std Rx -](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$0 |
to be determined |
3 |
Tier 3 |
$74.00 | $148.00 | None | $6,513.96 |
Browse Plan Formulary |
Medica Prime Sol. Enhanced w/Enhanced Rx -
![Email Prescription and/or Health Benefit details for Medica Prime Sol. Enhanced w/Enhanced Rx -](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.90 |
$0 |
to be determined |
3 |
Tier 3 |
$74.00 | $148.00 | None | $6,513.96 |
Browse Plan Formulary |
Medica Prime Solution Basic w/Enhanced Rx
![Email Prescription and/or Health Benefit details for Medica Prime Solution Basic w/Enhanced Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$67.90 |
$0 |
to be determined |
3 |
Tier 3 |
$74.00 | $68.00 | None | $6,513.96 |
Browse Plan Formulary |