CYCLOPHOSPHAMIDE 1GM VIAL (75 mL VIAL) (NDC: 10019095601)
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 |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $58.69 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $58.69 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $58.69 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $57.26 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $57.26 |
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 |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | P | $57.26 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
2 |
Tier 2 |
$25.00 | $50.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $55.79 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $12.00 | None | $85.95 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $12.00 | None | $85.95 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
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 |
1 |
Tier 1 |
$6.00 | $12.00 | None | $84.84 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
1 |
Tier 1 |
$7.00 | $17.50 | None | $58.79 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-101 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-101 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.40 |
$0 |
to be determined |
1 |
Tier 1 |
$9.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-101 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-101 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.40 |
$0 |
to be determined |
1 |
Tier 1 |
$9.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.50 |
$0 |
to be determined |
2 |
Tier 2 |
$32.00 | $64.00 | P | $75.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-077 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-077 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-077 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-077 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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) |
$22.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $87.99 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $75.89 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 |
2 |
Tier 2 |
$35.00 | $87.50 | P | $81.22 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $57.87 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
1 |
Tier 1 |
$4.00 | $8.00 | P | $57.26 |
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 |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
1 |
Tier 1 |
$4.00 | $8.00 | P | $57.26 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
1 |
Tier 1 |
$4.00 | $8.00 | P | $57.26 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | None | $85.95 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | None | $85.95 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | None | $85.95 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | None | $85.95 |
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 H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.30 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-081 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-081 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | P | $83.05 |
Browse Plan Formulary |
Keystone 65 Advantage Rx (HMO)
![Email Prescription and/or Health Benefit details for Keystone 65 Advantage Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.30 |
$280 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | None | $75.96 |
Browse Plan Formulary |
Evercare Plan IP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan IP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | None | $85.95 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | None | $83.85 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $88.13 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $72.50 |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
1 |
Tier 1 |
$0.00 | $0.00 | None | $88.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
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 H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $0.00 | P | $98.39 |
Browse Plan Formulary |
HumanaChoice R5826-002 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-002 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.70 |
$0 |
to be determined |
1 |
Tier 1 |
$10.00 | $0.00 | P | $83.05 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $60.00 | P | $75.31 |
Browse Plan Formulary |
Keystone 65 Preferred Rx (HMO)
![Email Prescription and/or Health Benefit details for Keystone 65 Preferred Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$41.30 |
$100 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | None | $75.96 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
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 |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
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 |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
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 |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
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 |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $12.50 | None | $88.13 |
Browse Plan Formulary |