CELEBREX 400MG CAPSULE (60 BOT) (NDC: 00025153002)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | Q:62 /31Days | $346.23 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | P Q:2 /1Days | $348.82 |
Browse Plan Formulary |
CIGNA Medicare Select Plus Rx (HMO)
![Email Prescription and/or Health Benefit details for CIGNA Medicare Select Plus Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $120.00 | Q:60 /30Days | $356.05 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $345.92 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $345.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $345.92 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $347.51 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $347.51 |
Browse Plan Formulary |
Health Net Ruby 4 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$41.00 | $82.00 | None | $348.37 |
Browse Plan Formulary |
Humana Gold Plus H0307-011 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0307-011 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | S Q:60 /30Days | $344.11 |
Browse Plan Formulary |
MediSunONE Classic (HMO)
![Email Prescription and/or Health Benefit details for MediSunONE Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SCAN Health Plan Arizona (HMO)
![Email Prescription and/or Health Benefit details for SCAN Health Plan Arizona (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$28.00 | $56.00 | S | $366.59 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
3 |
Tier 3 |
$85.00 | $212.50 | P Q:60 /30Days | $372.27 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.30 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.12 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.38 |
Browse Plan Formulary |
Desert Canyon Community Care - Plus (HMO)
![Email Prescription and/or Health Benefit details for Desert Canyon Community Care - Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.80 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $348.38 |
Browse Plan Formulary |
CIGNA Medicare Select Plus Rx-Dual (HMO)
![Email Prescription and/or Health Benefit details for CIGNA Medicare Select Plus Rx-Dual (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.70 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | Q:60 /30Days | $356.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP MedicareComplete Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.90 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $346.22 |
Browse Plan Formulary |
AARP MedicareComplete Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.90 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | Q:62 /31Days | $346.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.30 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.69 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.69 |
Browse Plan Formulary |
Desert Canyon Community Care - Plus Point
![Email Prescription and/or Health Benefit details for Desert Canyon Community Care - Plus Point](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.60 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $348.38 |
Browse Plan Formulary |
Evercare Plan DH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan DH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.80 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | Q:62 /31Days | $347.51 |
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 | Q:180 /90Days | $350.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.48 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.60 |
$310 |
to be determined |
2 |
Tier 2 |
25% | n/a | P Q:60 /30Days | $352.41 |
Browse Plan Formulary |
MediSunONE Plus (HMO)
![Email Prescription and/or Health Benefit details for MediSunONE Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$100 |
to be determined |
4 |
Tier 4 |
$60.00 | $165.00 | None | $362.43 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | Q:180 /90Days | $350.51 |
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 | Q:180 /90Days | $350.51 |
Browse Plan Formulary |
Health Net Ruby 1 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
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 |
Health Net Ruby 3 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
Browse Plan Formulary |
Health Net Ruby 3 (HMO)
![Email Prescription and/or Health Benefit details for Health Net Ruby 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $84.00 | None | $348.37 |
Browse Plan Formulary |
SCAN Health Plan Arizona (HMO)
![Email Prescription and/or Health Benefit details for SCAN Health Plan Arizona (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.00 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | S | $366.59 |
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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.45 |
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 | Q:180 /90Days | $350.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | Q:180 /90Days | $350.45 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.60 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.38 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.60 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.38 |
Browse Plan Formulary |
Humana Gold Plus H0307-008 (HMO)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0307-008 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | S Q:60 /30Days | $344.11 |
Browse Plan Formulary |
Humana Gold Plus H0307-010 (HMO-POS)
![Email Prescription and/or Health Benefit details for Humana Gold Plus H0307-010 (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | S Q:60 /30Days | $344.11 |
Browse Plan Formulary |
Maricopa Care Advantage (HMO)
![Email Prescription and/or Health Benefit details for Maricopa Care Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | S | $358.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Mercy Care Advantage (HMO)
![Email Prescription and/or Health Benefit details for Mercy Care Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | Q:68 /34Days | $362.44 |
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 | Q:180 /90Days | $350.48 |
Browse Plan Formulary |
Health Choice Generations (HMO)
![Email Prescription and/or Health Benefit details for Health Choice Generations (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.70 |
$0 |
to be determined |
2 |
Tier 2 |
$6.30 | $6.30 | S | $358.35 |
Browse Plan Formulary |
Health Choice Generations (HMO)
![Email Prescription and/or Health Benefit details for Health Choice Generations (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.70 |
$0 |
to be determined |
2 |
Tier 2 |
$6.30 | $6.30 | S | $358.35 |
Browse Plan Formulary |
Health Net Amber (HMO)
![Email Prescription and/or Health Benefit details for Health Net Amber (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.70 |
$310 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | None | $348.37 |
Browse Plan Formulary |
Abrazo Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Abrazo Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.80 |
$310 |
to be determined |
2 |
Tier 2 |
15% | n/a | S | $358.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
APIPA Personal Care Plus (HMO)
![Email Prescription and/or Health Benefit details for APIPA Personal Care Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.80 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | S Q:62 /31Days | $347.04 |
Browse Plan Formulary |
Evercare Plan IP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan IP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.80 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | Q:62 /31Days | $347.45 |
Browse Plan Formulary |
Abrazo Advantage (HMO)
![Email Prescription and/or Health Benefit details for Abrazo Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $120.00 | S | $358.35 |
Browse Plan Formulary |
Humana Gold Choice H2944-028 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-028 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $346.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-028 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-028 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.20 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $346.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-029 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-029 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $346.27 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-029 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-029 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $346.27 |
Browse Plan Formulary |
Humana Gold Choice H2944-030 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-030 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.40 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $342.12 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-031 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $345.01 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-031 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $345.01 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-031 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $345.01 |
Browse Plan Formulary |
Humana Gold Choice H2944-031 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-031 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $95.00 | S Q:60 /30Days | $345.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-076 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-076 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.20 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | S Q:60 /30Days | $344.95 |
Browse Plan Formulary |
HumanaChoice H0317-002 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H0317-002 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.70 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | S Q:60 /30Days | $344.22 |
Browse Plan Formulary |
HumanaChoice R5826-014 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-014 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | S Q:60 /30Days | $344.95 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.10 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.60 |
Browse Plan Formulary |
MediSunONE HeartSmart (HMO)
![Email Prescription and/or Health Benefit details for MediSunONE HeartSmart (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$50 |
to be determined |
4 |
Tier 4 |
$60.00 | $165.00 | None | $362.43 |
Browse Plan Formulary |
MediSunONE Premier (HMO)
![Email Prescription and/or Health Benefit details for MediSunONE Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$50 |
to be determined |
4 |
Tier 4 |
$60.00 | $165.00 | None | $362.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.69 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H0317-001 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H0317-001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | S Q:60 /30Days | $344.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.80 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | n/a | P Q:60 /30Days | $352.41 |
Browse Plan Formulary |