CARDENE IV INJECTION 2.5MG/ML 10 X 10 ML AMP (10 X 10 ML AMP) (NDC: 24477003025)
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 |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$59.00 | $118.00 | None | $2,362.52 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$59.00 | $118.00 | None | $2,362.52 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$59.00 | $118.00 | None | $2,362.52 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$59.00 | $118.00 | None | $2,362.52 |
Browse Plan Formulary |
Humana Gold Choice H1804-290 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-290 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $2,114.37 |
Browse Plan Formulary |
Clear Care Vital (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Vital (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.00 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $2,403.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $2,416.68 |
Browse Plan Formulary |
Clear Care Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.40 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $2,403.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-063 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-063 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-064 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-064 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Care Optimal (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Optimal (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.10 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $2,403.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $2,416.68 |
Browse Plan Formulary |