ARANESP SINGLE USE VIAL 40MCG 4 X 40MCG/ 1ML VIALSD (4 X 40MCG/ 1ML VIALSD) (NDC: 55513000304)
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 |
Advantra Elite (PPO)
![Email Prescription and/or Health Benefit details for Advantra Elite (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $207.00 | P S Q:4 /28Days | $890.57 |
Browse Plan Formulary |
Advantra Silver (HMO)
![Email Prescription and/or Health Benefit details for Advantra Silver (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$68.00 | $204.00 | P S Q:4 /28Days | $890.23 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
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 | $938.33 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
FreedomBlue PPO HD Rx (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO HD Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Choice (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | $185.00 | P | $895.89 |
Browse Plan Formulary |
UPMC for Life PPO High Deductible with Rx
![Email Prescription and/or Health Benefit details for UPMC for Life PPO High Deductible with Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P | $933.41 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
3 |
Tier 3 |
$26.00 | $52.00 | P | $905.29 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
SecurityBlue Basic (HMO)
![Email Prescription and/or Health Benefit details for SecurityBlue Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.20 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.20 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.20 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.20 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CC
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CC](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 2 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.58 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 2 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $945.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $945.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.07 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $913.70 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $913.70 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $895.09 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $926.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $926.84 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $926.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $926.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $945.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
3 |
Tier 3 |
25% | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 3 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 3 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $939.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.90 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $924.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $904.64 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
SeniorBlue - Option 3 (PPO)
![Email Prescription and/or Health Benefit details for SeniorBlue - Option 3 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.00 | P | $933.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.45 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
3 |
Tier 3 |
$38.00 | $76.00 | P | $909.87 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 |
4 |
Tier 4 |
33% | 33% | P | $942.03 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $938.33 |
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 | $928.89 |
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 | $928.89 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $928.89 |
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 | $928.89 |
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 | $928.89 |
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 | $979.74 |
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 | $979.74 |
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 | $979.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 | $979.74 |
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 | $979.74 |
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 | $928.89 |
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 | $928.89 |
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 | $928.89 |
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 | $928.89 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $928.89 |
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 | $979.74 |
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 | $979.74 |
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 | $979.74 |
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 | $979.74 |
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 | $979.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
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 | $930.32 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 1 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.70 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | P Q:24 /90Days | $876.92 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
FreedomBlue PPO Select (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.50 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $919.42 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $891.89 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $891.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $891.89 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $891.89 |
Browse Plan Formulary |
SecurityBlue Care (HMO)
![Email Prescription and/or Health Benefit details for SecurityBlue Care (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | None | $891.15 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $80.00 | P | $908.26 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.30 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $945.14 |
Browse Plan Formulary |
Bravo Premier (HMO)
![Email Prescription and/or Health Benefit details for Bravo Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
SecurityBlue Standard (HMO)
![Email Prescription and/or Health Benefit details for SecurityBlue Standard (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.70 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $935.12 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $898.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $932.42 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (HMO)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
3 |
Tier 3 |
$68.00 | $204.00 | P S Q:4 /28Days | $890.23 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.70 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P S Q:4 /28Days | $892.05 |
Browse Plan Formulary |
Bravo Select (HMO)
![Email Prescription and/or Health Benefit details for Bravo Select (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Bravo Traditions (HMO)
![Email Prescription and/or Health Benefit details for Bravo Traditions (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P Q:8 /30Days | $890.73 |
Browse Plan Formulary |
Gateway Health Plan Medicare Assured (HMO)
![Email Prescription and/or Health Benefit details for Gateway Health Plan Medicare Assured (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$310 |
to be determined |
3 |
Tier 3 |
$94.75 | n/a | P | $901.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P Q:12 /28Days | $895.05 |
Browse Plan Formulary |
Unison Advantage Plus Integrated Care (HMO
![Email Prescription and/or Health Benefit details for Unison Advantage Plus Integrated Care (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P Q:12 /28Days | $894.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $270.00 | P | $933.41 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.50 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $912.98 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $882.04 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $878.15 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $877.18 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $936.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $905.30 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | P Q:2 /14Days | $881.86 |
Browse Plan Formulary |
UPMC for Life HMO Rx (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life HMO Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life HMO Rx Enhanced (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life HMO Rx Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P | $933.41 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
![Email Prescription and/or Health Benefit details for Today's Options Advantage 3 powered by CCR](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.70 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $938.07 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $918.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $915.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $914.58 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.20 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | P Q:8 /28Days | $936.11 |
Browse Plan Formulary |
Advantra Gold (PPO)
![Email Prescription and/or Health Benefit details for Advantra Gold (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
3 |
Tier 3 |
$67.00 | $201.00 | P S Q:4 /28Days | $890.57 |
Browse Plan Formulary |
FreedomBlue PPO Classic (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $891.15 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $933.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.52 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | P | $937.80 |
Browse Plan Formulary |
SecurityBlue Deluxe (HMO)
![Email Prescription and/or Health Benefit details for SecurityBlue Deluxe (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$46.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $891.15 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $933.41 |
Browse Plan Formulary |
FreedomBlue PPO Platinum (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Platinum (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$83.30 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $891.15 |
Browse Plan Formulary |