CELLCEPT CAPSULES 250MG (500 CT) (500 BOT) (NDC: 00004025943)
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 |
Arkansas Community Care - Plus (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Plan Name |
Monthly 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 MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 MedicareADVANTAGE AR Plan 2 (PPO)
![Email Prescription and/or Health Benefit details for Mercy MedicareADVANTAGE AR Plan 2 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,143.85 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
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 | $1,140.43 |
Browse Plan Formulary |
Windsor Medicare Extra Emerald Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Emerald Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $105.00 | P | $1,068.48 |
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 |
HumanaChoice H4520-016 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4520-016 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$6.60 |
$0 |
to be determined |
2 |
Tier 2 |
$41.00 | $102.50 | P | $1,051.19 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | P | $1,062.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Gold Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Gold Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $105.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
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 |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
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 |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Plus Point (HMO-](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.90 |
$0 |
to be determined |
3 |
Tier 3 |
$44.00 | $88.00 | P | $1,068.48 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD O](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.10 |
$0 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
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 |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
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 |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
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 |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-009 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.50 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.69 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD (
![Email Prescription and/or Health Benefit details for AR Blue Cross - Medi-Pak Advantage MA-PD (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.70 |
$170 |
to be determined |
2 |
Tier 2 |
$36.00 | $90.00 | P | $1,068.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,085.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,081.14 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,078.47 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | P | $1,106.12 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-010 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,064.41 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Diamond Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Diamond Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $105.00 | P | $1,068.48 |
Browse Plan Formulary |
Windsor Medicare Extra Diabetes Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Diabetes Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
to be determined |
3 |
Tier 3 |
$25.00 | $75.00 | P | $1,068.48 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
to be determined |
3 |
Tier 3 |
$25.00 | $75.00 | P | $1,068.48 |
Browse Plan Formulary |
HumanaChoice H7188-003 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H7188-003 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | P | $1,063.67 |
Browse Plan Formulary |
Arkansas Community Care - Dual Plus (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Dual Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
2 |
Tier 2 |
n/a | n/a | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
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 |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
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 |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
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 |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
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 |
Arkansas Community Care - Enhanced (HMO)
![Email Prescription and/or Health Benefit details for Arkansas Community Care - Enhanced (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.50 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P | $1,068.48 |
Browse Plan Formulary |
HumanaChoice R5826-010 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-010 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $1,059.92 |
Browse Plan Formulary |