FENTANYL 12MCG/HR PATCH TRANSDERMAL 72 HOURS (5 SYSTEM POU) (NDC: 00378911998)
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 |
Arkansas Community Care - Plus (HMO)
|
$0.00 |
$0 | to be determined | 2 |
Tier 2 |
$15.00 | $30.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
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 |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
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 |
Mercy MedicareADVANTAGE AR Plan 2 (PPO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,796.21 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Standard (HMO)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $12.00 | Q:15 /30Days | $1,688.89 |
Browse Plan Formulary |
Windsor Medicare Extra Emerald Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | S Q:10 /30Days | $1,581.04 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,696.77 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,704.16 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,704.16 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
|
$6.60 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $0.00 | Q:20 /30Days | $2,317.28 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.37 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.37 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.37 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.37 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$9.90 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,717.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,687.56 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,687.56 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 2 |
Tier 2 |
$42.00 | $116.00 | Q:15 /31Days | $1,616.41 |
Browse Plan Formulary |
Care Improvement Plus Medicare Advantage (
|
$11.40 |
$0 | to be determined | 1 |
Tier 1 |
$9.00 | $22.50 | None | $1,651.58 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 1 |
Tier 1 |
25% | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Windsor Medicare Extra Gold Plan (HMO)
|
$15.20 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | S Q:10 /30Days | $1,581.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Arkansas Community Care - Plus Point (HMO-
|
$15.90 |
$0 | to be determined | 2 |
Tier 2 |
$12.00 | $24.00 | Q:10 /25Days | $1,554.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,694.98 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,704.16 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,704.16 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,703.80 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,601.02 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,243.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD (
|
$21.70 |
$170 | to be determined | 1 |
Tier 1 |
$7.00 | $17.50 | Q:10 /25Days | $1,554.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,701.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,645.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,633.66 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,638.74 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 2 |
Tier 2 |
$35.00 | $87.50 | Q:20 /30Days | $1,632.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 1 |
Tier 1 |
$8.00 | $0.00 | Q:20 /30Days | $2,267.78 |
Browse Plan Formulary |
Windsor Medicare Extra Diamond Plan (HMO)
|
$25.80 |
$0 | to be determined | 4 |
Tier 4 |
$60.00 | $180.00 | S Q:10 /30Days | $1,581.04 |
Browse Plan Formulary |
Windsor Medicare Extra Diabetes Plan (HMO)
|
$27.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | S Q:10 /30Days | $1,581.04 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$27.00 |
$0 | to be determined | 4 |
Tier 4 |
$45.00 | $135.00 | S Q:10 /30Days | $1,581.04 |
Browse Plan Formulary |
Arkansas Community Care - Dual Plus (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /25Days | $1,590.69 |
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 |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
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 |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
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 |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
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 |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Arkansas Community Care - Enhanced (HMO)
|
$28.50 |
$310 | to be determined | 2 |
Tier 2 |
25% | 25% | Q:10 /25Days | $1,590.69 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Select (HMO)
|
$28.50 |
$310 | to be determined | 1 |
Tier 1 |
n/a | n/a | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
HumanaChoice R5826-010 (Regional PPO)
|
$30.80 |
$310 | to be determined | 1 |
Tier 1 |
25% | 25% | Q:20 /30Days | $2,218.37 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Physicians Health Choice Extra (HMO)
|
$37.30 |
$0 | to be determined | 1 |
Tier 1 |
$0.00 | $0.00 | Q:10 /30Days | $1,533.97 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,696.77 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,698.33 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,704.91 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,491.45 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 1 |
Tier 1 |
$10.00 | $20.00 | None | $1,490.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,687.56 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,687.56 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,717.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,707.82 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 1 |
Tier 1 |
$5.00 | n/a | Q:16 /30Days | $1,686.03 |
Browse Plan Formulary |