BACTROBAN NASAL 2% OINTMENT (10 X 1 GM TUBES BOX) (NDC: 00029152611)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantra Gold (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | None | $88.86 |
Browse Plan Formulary |
BlueValue Basic (HMO)
![Email Prescription and/or Health Benefit details for BlueValue Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.73 |
Browse Plan Formulary |
BlueValue Secure (HMO)
![Email Prescription and/or Health Benefit details for BlueValue Secure (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.73 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.55 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $94.56 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.48 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
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 |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
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 |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
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 |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
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 |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
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 |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
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 |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
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 |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-113 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-117 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-117 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-117 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-117 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-117 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-117 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | None | $89.48 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-116 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-116 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
HumanaChoice H5214-009 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5214-009 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $88.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
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 |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-114 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $89.20 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Preferred NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Preferred NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Preferred NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $90.08 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $90.08 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $90.08 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.60 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $90.08 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
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 H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-115 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.10 |
Browse Plan Formulary |
HumanaChoice H5214-010 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5214-010 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $88.32 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-118 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-118 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-118 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-118 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-118 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-118 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $90.07 |
Browse Plan Formulary |
HumanaChoice R5826-004 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-004 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$84.00 | $210.00 | None | $89.15 |
Browse Plan Formulary |
HumanaChoice R5826-077 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-077 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.10 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $89.15 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyAdvantage Select NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.50 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HealthSpring HealthyAdvantage Select NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyAdvantage Select NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.50 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyAdvantage Select NGA (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.50 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | None | $88.31 |
Browse Plan Formulary |