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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$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 |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $1,423.51 |
Browse Plan Formulary |
HumanaChoice H4520-016 (PPO)
|
$6.60 |
$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 |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$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
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $1,663.01 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
|
$20.00 |
$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 |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AR Blue Cross - Medi-Pak Advantage MA-PD O
|
$21.10 |
$0 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$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 H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$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 H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-009 (PFFS)
|
$21.50 |
$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 |
AR Blue Cross - Medi-Pak Advantage MA-PD (
|
$21.70 |
$170 | to be determined | 3 |
Tier 3 |
$76.00 | $190.00 | None | $1,661.89 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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
|
$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 |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$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 H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
Humana Gold Choice H2944-010 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,626.84 |
Browse Plan Formulary |
HumanaChoice R5826-010 (Regional PPO)
|
$30.80 |
$310 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $1,626.84 |
Browse Plan Formulary |