AZASITE 1% DROPS (1 X 2.5 ML CRTN BOT) (NDC: 31357004025)
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 |
Choices Plus (HMO-POS)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$50.00 | $100.00 | None | $76.48 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-009 (PFFS)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Plus H1951-001 (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $75.13 |
Browse Plan Formulary |
Humana Gold Plus H1951-001 (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $75.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Plus H1951-001 (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $75.13 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
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 |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
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 |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
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 |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.75 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.67 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $78.10 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 2 |
Tier 2 |
25% | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 3 |
Tier 3 |
$35.00 | $70.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.58 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.57 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.66 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.81 |
Browse Plan Formulary |
Humana Gold Plus H1951-013 (HMO)
|
$18.90 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $74.47 |
Browse Plan Formulary |
Humana Gold Plus H1951-013 (HMO)
|
$18.90 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $74.47 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Plus Point (HMO-
|
$19.40 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $76.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.05 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $78.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $77.08 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | None | $76.88 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
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 |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
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 |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$30.00 | $60.00 | None | $76.60 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
Browse Plan Formulary |
Humana Gold Choice H1906-001 (PFFS)
|
$24.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | None | $75.10 |
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 |
Humana Gold Plus SNP-DE H1951-017 (HMO)
|
$29.70 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $112.50 | None | $75.13 |
Browse Plan Formulary |
Humana Gold Plus SNP-DE H1951-017 (HMO)
|
$29.70 |
$0 | to be determined | 2 |
Tier 2 |
$45.00 | $112.50 | None | $75.13 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
Arcadian Community Care - Enhanced (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.14 |
Browse Plan Formulary |
HumanaChoice R5826-078 (Regional PPO)
|
$31.30 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | None | $75.14 |
Browse Plan Formulary |
Secure Health (HMO)
|
$31.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $76.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-011 (Regional PPO)
|
$34.30 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $105.00 | None | $75.14 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.77 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $78.10 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $78.10 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.72 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AAA2 Vantage BASIC (HMO-POS)
|
$49.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $240.00 | None | $77.49 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.71 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.71 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.83 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | n/a | Q:3 /30Days | $77.76 |
Browse Plan Formulary |