LANREOTIDE INJECTION 30MG (NDC: 15054009001)
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,535.08 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
New West Medicare (PPO)
![Email Prescription and/or Health Benefit details for New West Medicare (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,204.58 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-052 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-052 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:1 /28Days | $2,470.30 |
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New West Medicare Enhanced (PPO)
![Email Prescription and/or Health Benefit details for New West Medicare Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $2,204.58 |
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