GRANISETRON HCL 1MG TABLET (20 CT) (20 BOT) (NDC: 64720019802)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete Plan 3 (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $107.00 | P Q:6 /3Days | $1,449.59 |
Browse Plan Formulary |
Community HealthFirst Medicare Advantage E
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $15.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Essence Advantage (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | P | $332.28 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | P | $332.28 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | P | $332.28 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | $10.00 | P | $332.28 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | P Q:6 /3Days | $1,366.28 |
Browse Plan Formulary |
Humana Gold Choice H1804-290 (PFFS)
|
$0.00 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $860.43 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 |
to be determined |
1 |
Tier 1 |
$8.00 | $12.00 | P Q:30 /30Days | $1,206.90 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
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
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
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
|
$6.50 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
Browse Plan Formulary |
Clear Care Vital (HMO)
|
$10.00 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $1,211.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.51 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | P Q:6 /3Days | $1,390.72 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$12.20 |
$0 |
to be determined |
2 |
Tier 2 |
$29.00 | $77.00 | P Q:6 /3Days | $1,435.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
1 |
Tier 1 |
25% | n/a | P | $2,957.90 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
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 Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.63 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
|
$17.50 |
$0 |
to be determined |
2 |
Tier 2 |
$38.00 | $104.00 | P Q:6 /3Days | $1,485.74 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | P Q:6 /3Days | $1,463.38 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | P Q:6 /3Days | $1,463.38 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | P Q:6 /3Days | $1,463.38 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | P Q:6 /3Days | $1,463.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 |
to be determined |
1 |
Tier 1 |
25% | 25% | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Care Essential (HMO)
|
$27.40 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $1,211.05 |
Browse Plan Formulary |
Community HealthFirst MA Plan with Pharmac
|
$32.90 |
$0 |
to be determined |
1 |
Tier 1 |
$14.00 | $42.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $1,007.19 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $1,007.19 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $1,007.19 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $1,007.19 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Community HealthFirst MA Plan with Pharmac
|
$35.60 |
$0 |
to be determined |
1 |
Tier 1 |
$13.00 | $39.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Community HealthFirst Medicare Advantage S
|
$35.60 |
$310 |
to be determined |
1 |
Tier 1 |
15% | 15% | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-063 (PFFS)
|
$36.10 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $860.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-064 (PFFS)
|
$36.10 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $860.43 |
Browse Plan Formulary |
Spokane Community Care - Premier (HMO)
|
$36.10 |
$0 |
to be determined |
2 |
Tier 2 |
$12.00 | $24.00 | P | $1,007.19 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Regence MedAdvantage + Rx Classic (PPO)
|
$38.80 |
$255 |
to be determined |
1 |
Tier 1 |
$4.00 | $12.00 | P Q:30 /30Days | $1,172.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
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
|
$38.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,960.03 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Clear Care Optimal (HMO)
|
$40.10 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $1,211.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,956.81 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,966.87 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,966.87 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.20 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 |
to be determined |
1 |
Tier 1 |
$10.00 | $20.00 | P Q:2 /1Days | $1,350.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | P Q:2 /1Days | $1,350.17 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 |
to be determined |
1 |
Tier 1 |
$6.00 | $0.00 | Q:28 /28Days | $866.61 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,962.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,961.13 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
1 |
Tier 1 |
$5.00 | n/a | P | $2,957.90 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Regence MedAdvantage + Rx Enhanced (PPO)
|
$66.60 |
$0 |
to be determined |
1 |
Tier 1 |
$4.00 | $12.00 | P Q:30 /30Days | $1,172.71 |
Browse Plan Formulary |