AREDIA 30MG VIAL (4 CRTN) (NDC: 00078046391)
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 |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
UCare for Seniors Value Plus (HMO-POS)
|
$2.80 |
$0 | to be determined | 3 |
Tier 3 |
$60.00 | $120.00 | None | $843.31 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,008.33 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
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 |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $843.31 |
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 |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advocare Essence Rx (HMO-POS)
|
$17.20 |
$0 | to be determined | 3 |
Tier 3 |
$60.00 | $180.00 | None | $951.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-069 (PFFS)
|
$20.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-007 (PPO)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
HumanaChoice H5216-008 (PPO)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
HumanaChoice H5216-008 (PPO)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
UCare for Seniors Classic (HMO-POS)
|
$21.50 |
$0 | to be determined | 3 |
Tier 3 |
$60.00 | $120.00 | None | $843.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Advocare Vitality Rx (HMO-POS)
|
$25.00 |
$0 | to be determined | 3 |
Tier 3 |
$60.00 | $180.00 | None | $951.91 |
Browse Plan Formulary |
Advocare Spirit Rx (HMO-POS)
|
$27.00 |
$0 | to be determined | 3 |
Tier 3 |
$60.00 | $180.00 | None | $951.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | Q:8 /30Days | $963.52 |
Browse Plan Formulary |
Medica Prime Solution Value (Cost)
|
$38.00 |
$55 | to be determined | 3 |
Tier 3 |
$74.00 | $148.00 | None | $986.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medica Prime Solution Basic w/Standard Rx
|
$38.90 |
$0 | to be determined | 3 |
Tier 3 |
$74.00 | $148.00 | None | $986.72 |
Browse Plan Formulary |
Medica Prime Solution Enhanced w/Standard
|
$38.90 |
$0 | to be determined | 3 |
Tier 3 |
$74.00 | $148.00 | None | $986.72 |
Browse Plan Formulary |
Medica Prime Solution Basic w/Enhanced Rx
|
$67.90 |
$0 | to be determined | 3 |
Tier 3 |
$74.00 | $148.00 | None | $986.72 |
Browse Plan Formulary |
Medica Prime Solution Enhanced w/Enhanced
|
$67.90 |
$0 | to be determined | 3 |
Tier 3 |
$74.00 | $148.00 | None | $986.72 |
Browse Plan Formulary |