COPEGUS 200MG TABLET (168 BOT) (NDC: 00004008694)
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 |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.50 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
![Email Prescription and/or Health Benefit details for SmartValue Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,370.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-067 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Advocare Essence Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advocare Essence Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,549.29 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-065 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-069 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-069 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
HumanaChoice H5216-007 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-007 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H5216-008 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-008 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
HumanaChoice H5216-008 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5216-008 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-070 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Advocare Vitality Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advocare Vitality Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,549.29 |
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 |
Advocare Spirit Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advocare Spirit Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,549.29 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
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 H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-066 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,568.23 |
Browse Plan Formulary |