IMDUR 120MG TABLET SA (NDC: 00085009101)
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $118.59 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
4 |
Tier 4 |
$70.00 | $140.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.45 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.53 |
Browse Plan Formulary |
HumanaChoice H4606-001 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H4606-001 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
$60.00 | $120.00 | None | $111.44 |
Browse Plan Formulary |
Humana Gold Choice H2944-057 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-057 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-057 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-057 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-057 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-057 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-057 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-057 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-057 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-057 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-055 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-055 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-058 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-058 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-058 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-058 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-058 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-058 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-058 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-058 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-058 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-058 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Humana Gold Choice H2944-056 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-056 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $109.56 |
Browse Plan Formulary |
Regence MedAdvantage + Rx Classic (PPO)
![Email Prescription and/or Health Benefit details for Regence MedAdvantage + Rx Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.60 |
$200 |
to be determined |
3 |
Tier 3 |
$56.00 | $168.00 | None | $22.09 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
![Email Prescription and/or Health Benefit details for Regence MedAdvantage + Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.30 |
$0 |
to be determined |
3 |
Tier 3 |
$56.00 | $168.00 | None | $22.09 |
Browse Plan Formulary |