HERCEPTIN 440MG VIAL (1 X VIAL AND DILUENT PKGCOM) (NDC: 50242013468)
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 | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
Essence Advantage (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,894.67 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,894.67 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,894.67 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
20% | 20% | P | $2,894.67 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
Humana Gold Choice H1804-290 (PFFS)
|
$0.00 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,984.49 |
Browse Plan Formulary |
Clear Care Vital (HMO)
|
$10.00 |
$310 | to be determined | 2 |
Tier 2 |
$17.00 | $51.00 | None | $2,943.90 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
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 |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
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 |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
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 |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
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 |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
|
$12.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
AARP MedicareComplete Plan 2 (HMO)
|
$12.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
|
$17.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
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 |
Evercare Plan MH (HMO)
|
$19.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$19.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $3,097.89 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,975.39 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,445.32 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,445.32 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,987.13 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$22.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $3,026.28 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
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 |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
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 |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
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 |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
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 |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
|
$25.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | P | $2,960.71 |
Browse Plan Formulary |
Clear Care Essential (HMO)
|
$27.40 |
$310 | to be determined | 2 |
Tier 2 |
$14.00 | $42.00 | None | $2,943.90 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $2,957.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $2,957.31 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $2,957.31 |
Browse Plan Formulary |
Spokane Community Care - Enhanced (HMO)
|
$35.50 |
$310 | to be determined | 5 |
Tier 5 |
25% | 25% | None | $2,957.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-063 (PFFS)
|
$36.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-064 (PFFS)
|
$36.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Spokane Community Care - Premier (HMO)
|
$36.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $2,957.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
|
$38.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Regence MedAdvantage + Rx Classic (PPO)
|
$38.80 |
$255 | to be determined | 5 |
Tier 5 |
26% | n/a | None | $3,044.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-062 (PFFS)
|
$39.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Clear Care Optimal (HMO)
|
$40.10 |
$0 | to be determined | 2 |
Tier 2 |
$15.00 | $45.00 | None | $2,943.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
|
$40.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
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 |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
|
$47.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,960.71 |
Browse Plan Formulary |
Kaiser Permanente Senior Advantage II (HMO
|
$51.90 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $80.00 | None | $2,991.25 |
Browse Plan Formulary |
Regence MedAdvantage + Rx Enhanced (PPO)
|
$66.60 |
$0 | to be determined | 5 |
Tier 5 |
30% | n/a | None | $3,044.89 |
Browse Plan Formulary |