AZACTAM/ISO-OSMOT 2GM/50ML (50 ML BAG) (NDC: 51479004901)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
Anthem Medicare Preferred Premier (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,444.36 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,444.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $245.00 | None | $1,727.10 |
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 |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $245.00 | None | $1,727.10 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $245.00 | None | $1,727.10 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $245.00 | None | $1,727.10 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $245.00 | None | $1,727.10 |
Browse Plan Formulary |
Optima Medicare Value Plus (PPO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.18 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,707.40 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,731.84 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,731.84 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
|
$0.10 |
$0 | to be determined | 3 |
Tier 3 |
$26.00 | $52.00 | None | $1,755.37 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
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 |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,671.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$9.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$9.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$9.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $230.00 | None | $1,680.54 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,701.12 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | None | $1,701.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,719.00 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
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 |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
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 |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$18.80 |
$0 | to be determined | 3 |
Tier 3 |
$79.00 | $227.00 | None | $1,727.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-097 (PFFS)
|
$20.70 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-098 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,650.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-079 (PFFS)
|
$22.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,650.66 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,754.58 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,687.38 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,920.90 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,920.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $1,920.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-078 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,632.66 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H2542-002 (PPO)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $1,650.66 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
|
$34.00 |
$0 | to be determined | 3 |
Tier 3 |
$33.00 | $66.00 | None | $1,667.65 |
Browse Plan Formulary |
Evercare Plan IH-POS (HMO-POS)
|
$34.20 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $1,727.10 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,699.20 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,695.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,744.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,697.64 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,701.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,701.12 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
|
$53.50 |
$0 | to be determined | 3 |
Tier 3 |
$36.00 | $72.00 | None | $1,667.65 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Optima Medicare Preferred Plus (PPO)
|
$69.20 |
$0 | to be determined | 2 |
Tier 2 |
$30.00 | $90.00 | None | $1,661.35 |
Browse Plan Formulary |