ATGAM 50MG/ML AMPUL (5 X 5 ML AMP) (NDC: 00009722402)
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 |
AARP MedicareComplete Choice Plan 2 (Regio
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Choice Plan 2 (Regio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
Browse Plan Formulary |
Advantage Choice POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Choice POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | n/a |
Browse Plan Formulary |
Advantage Plus POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plus POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | P | n/a |
Browse Plan Formulary |
Advantage Premium POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Premium POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$15.00 | $30.00 | P | n/a |
Browse Plan Formulary |
CareFree (HMO)
![Email Prescription and/or Health Benefit details for CareFree (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CareFree (HMO)
![Email Prescription and/or Health Benefit details for CareFree (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
CareOne (HMO)
![Email Prescription and/or Health Benefit details for CareOne (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$0.00 | $0.00 | None | $2,765.27 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,893.39 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H1036-047 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-047 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H1036-081D (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H1036-081D (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-008 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-008 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-019 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-019 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 HealthCare Plans MedicareMax Direct
![Email Prescription and/or Health Benefit details for Medica HealthCare Plans MedicareMax Direct](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $2,850.05 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Standard (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | n/a | P | $2,617.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Standard (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | n/a | P | $2,617.97 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,798.69 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,798.69 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,798.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,798.69 |
Browse Plan Formulary |
Preferred Care Partners Preferred Freedom
![Email Prescription and/or Health Benefit details for Preferred Care Partners Preferred Freedom](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,798.69 |
Browse Plan Formulary |
Preferred Care Partners Senior Health Choi
![Email Prescription and/or Health Benefit details for Preferred Care Partners Senior Health Choi](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | 20% | None | $2,798.69 |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Plus H5426-002 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H5426-002 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.70 |
$0 |
to be determined |
4 |
Tier 4 |
20% | n/a | P | $2,617.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
![Email Prescription and/or Health Benefit details for Physicians Health Choice Extra (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.70 |
$0 |
to be determined |
4 |
Tier 4 |
20% | n/a | P | $2,617.97 |
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) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare HMO (HMO)
![Email Prescription and/or Health Benefit details for BlueMedicare HMO (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$105 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,826.54 |
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 | $2,826.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-138 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-138 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-139 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-139 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.60 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-141 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-141 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
HumanaChoice R5826-074 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-074 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |
BlueMedicare Regional PPO (Regional PPO)
![Email Prescription and/or Health Benefit details for BlueMedicare Regional PPO (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.70 |
$90 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$33.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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 |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-140 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-140 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | None | $2,765.27 |
Browse Plan Formulary |
HumanaChoice R5826-005 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-005 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.80 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$36.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-142 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-142 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-143 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-143 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.40 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
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) |
$39.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$39.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $180.00 | P | $2,839.00 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $180.00 | P | $2,839.00 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
3 |
Tier 3 |
25% | 25% | None | $2,403.10 |
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) |
$46.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$46.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
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) |
$46.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $2,793.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-144 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-144 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$48.70 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $2,765.27 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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 |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
Browse Plan Formulary |
BlueMedicare PFFS (PFFS)
![Email Prescription and/or Health Benefit details for BlueMedicare PFFS (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$49.50 |
$145 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $2,805.12 |
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) |
$54.40 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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) |
$54.40 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
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 |
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) |
$54.40 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $2,793.64 |
Browse Plan Formulary |