FEMHRT 1/5 TABLET (90 TABLETS BOT) (NDC: 00430054423)
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 |
Windsor Medicare Extra Emerald Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $66.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $140.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.89 |
Browse Plan Formulary |
Windsor Medicare Extra Gold Plan (HMO)
|
$15.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $120.00 | None | $69.92 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
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 |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 3 |
Tier 3 |
$85.00 | $212.50 | None | $74.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.59 |
Browse Plan Formulary |
Windsor Medicare Extra Diabetes Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Diamond Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | None | $66.74 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $64.87 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H4408-001 (PPO)
|
$34.40 |
$0 | to be determined | 3 |
Tier 3 |
$80.00 | $200.00 | None | $65.60 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | None | $69.17 |
Browse Plan Formulary |
Plan Name |
Monthly 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 NMS (
|
$42.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $71.33 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NMS (
|
$42.70 |
$0 | to be determined | 4 |
Tier 4 |
$70.00 | $210.00 | None | $71.33 |
Browse Plan Formulary |