NIPENT FOR INJECTION 10MG VIALS ( VIALS VIAL) (NDC: 00409080101)
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
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 |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
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 |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,552.67 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue Choice Value (HMO)
![Email Prescription and/or Health Benefit details for Medicare Blue Choice Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.40 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Medicare Blue PPO - Plan 201 (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - Plan 201 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
Humana Gold Choice H4774-004 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-004 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Medicare Blue Choice Value Plus (HMO)
![Email Prescription and/or Health Benefit details for Medicare Blue Choice Value Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,655.17 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
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) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Plan Name |
Monthly 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
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Blue Choice Senior (Cost)
![Email Prescription and/or Health Benefit details for Blue Choice Senior (Cost)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.30 |
$110 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $989.08 |
Browse Plan Formulary |
Humana Gold Choice H4774-003 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-003 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |
Medicare Blue Choice Optimum (HMO)
![Email Prescription and/or Health Benefit details for Medicare Blue Choice Optimum (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
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 |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Preferred Gold Rx (HMO)
![Email Prescription and/or Health Benefit details for Preferred Gold Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,659.50 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,655.17 |
Browse Plan Formulary |
GoldValue Rx (HMO)
![Email Prescription and/or Health Benefit details for GoldValue Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,659.50 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P Q:1 /1Days | $1,661.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,641.74 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
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 |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $1,641.30 |
Browse Plan Formulary |
GoldAnywhere Rx (PPO)
![Email Prescription and/or Health Benefit details for GoldAnywhere Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$60.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $1,659.50 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
MediBlue Plus (PPO)
![Email Prescription and/or Health Benefit details for MediBlue Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$70.20 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $1,745.34 |
Browse Plan Formulary |