DURAMORPH 0.5MG/ML AMPUL (10 X 10ML AMP) (NDC: 60977001602)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete Plus (HMO-POS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$4.00 | $8.00 | None | $117.68 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $16.00 | P | $102.94 |
Browse Plan Formulary |
BlueValue Basic (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
BlueValue Secure (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Humana Gold Plus H4141-001 (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage Basic (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $107.69 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage Enhance
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $16.00 | None | $107.69 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
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 |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $100.31 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 1 |
Tier 1 |
$6.00 | $12.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | None | $117.68 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
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 |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
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 |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
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 |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
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 |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 2 |
Tier 2 |
$10.00 | $20.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $40.85 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$20.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
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
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $121.07 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | P | $116.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 2 |
Tier 2 |
$7.00 | $14.00 | None | $39.39 |
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 H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Senior Advantage Medicare Medicaid Plan (H
|
$23.90 |
$0 | to be determined | 1 |
Tier 1 |
$12.00 | $24.00 | None | $107.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | P | $102.94 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | P | $102.94 |
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 (PPO)
|
$30.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | P | $102.94 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | P | $102.94 |
Browse Plan Formulary |
HumanaChoice H5214-003 (PPO)
|
$31.20 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
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 H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
HumanaChoice R5826-004 (Regional PPO)
|
$33.30 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | None | $114.10 |
Browse Plan Formulary |
HumanaChoice R5826-077 (Regional PPO)
|
$35.10 |
$310 | to be determined | 1 |
Tier 1 |
25% | 25% | None | $114.10 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $116.96 |
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)
|
$49.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | $10.00 | P | $102.94 |
Browse Plan Formulary |