FASLODEX 250MG/5ML SYRINGE (NDC: 00310072050)
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 |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Advantra Gold (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /30Days | $846.48 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Dual Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | None | n/a |
Browse Plan Formulary |
Southeast Community Care - Plus (HMO)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $836.68 |
Browse Plan Formulary |
Southeast Community Care - Plus (HMO)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $836.68 |
Browse Plan Formulary |
Southeast Community Care - Plus (HMO)
|
$0.00 |
$0 | to be determined | 3 |
Tier 3 |
$44.00 | $88.00 | None | $836.68 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$1.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$4.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $861.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $876.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
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 |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.69 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $847.06 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $876.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Care Improvement Plus Medicare Advantage (
|
$12.10 |
$0 | to be determined | 2 |
Tier 2 |
$37.00 | $92.50 | None | $857.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
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 |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.94 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $856.01 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
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 |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-113 (PFFS)
|
$18.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $864.71 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-117 (PFFS)
|
$22.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Southeast Community Care - Enhanced (HMO)
|
$22.30 |
$310 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $847.79 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.35 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $881.68 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $891.72 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $868.16 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $846.78 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$23.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $855.50 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-116 (PFFS)
|
$23.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-114 (PFFS)
|
$25.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HealthSpring HealthyLiving Preferred NGA (
|
$26.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $862.68 |
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 |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $846.41 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $846.41 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $846.41 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
|
$30.60 |
$0 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $846.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-115 (PFFS)
|
$31.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-118 (PFFS)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
HumanaChoice R5826-004 (Regional PPO)
|
$33.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
HumanaChoice R5826-077 (Regional PPO)
|
$35.10 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | Q:5 /30Days | $837.61 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $876.25 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $859.32 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $876.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $885.58 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $886.10 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HealthSpring HealthyAdvantage Select NGA (
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $857.21 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $885.60 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $858.43 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:5 /28Days | $861.29 |
Browse Plan Formulary |