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 |
Central Health Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $6,522.29 |
Browse Plan Formulary |
Central Health Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $6,522.29 |
Browse Plan Formulary |
Central Health Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Central Health Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $6,522.29 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
Freedom Blue Plan I (Regional PPO)
![Email Prescription and/or Health Benefit details for Freedom Blue Plan I (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Humana Gold Choice H1804-290 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-290 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$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 |
Freedom Blue Plus (Regional PPO)
![Email Prescription and/or Health Benefit details for Freedom Blue Plus (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$2.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby Plan 2 (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby Plan 2 (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby Plan 2 (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby Plan 2 (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Seniority Plus Ruby Plan 2 (HMO
![Email Prescription and/or Health Benefit details for Health Net Seniority Plus Ruby Plan 2 (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$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)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
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 H2944-072 (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 H2944-072 (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 H2944-072 (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 |
Health Net Healthy Heart Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$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 H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$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 H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$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 H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$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 H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-033 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-033 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Health Net Healthy Heart (HMO)
![Email Prescription and/or Health Benefit details for Health Net Healthy Heart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $6,455.36 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$310 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | P | $6,753.63 |
Browse Plan Formulary |
Healthy Advantage (HMO)
![Email Prescription and/or Health Benefit details for Healthy Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$310 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | P | $6,753.63 |
Browse Plan Formulary |
WHA Care+ (HMO)
![Email Prescription and/or Health Benefit details for WHA Care+ (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.60 |
$0 |
to be determined |
3 |
Tier 3 |
$95.00 | $237.50 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
WHA Care+ (HMO)
![Email Prescription and/or Health Benefit details for WHA Care+ (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.60 |
$0 |
to be determined |
3 |
Tier 3 |
$95.00 | $237.50 | None | n/a |
Browse Plan Formulary |
WHA Care+ (HMO)
![Email Prescription and/or Health Benefit details for WHA Care+ (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.60 |
$0 |
to be determined |
3 |
Tier 3 |
$95.00 | $237.50 | None | n/a |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$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 H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$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 H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$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 H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$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 H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-032 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-032 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$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 H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$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 H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$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 H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-034 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-034 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |