NISOLDIPINE 40MG TB24 (NDC: 00378222401)
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 |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $20.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.76 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
2 |
Tier 2 |
$7.00 | $14.00 | None | $129.49 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-084 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
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 H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
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 H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
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 H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-087 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $164.36 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
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 |
1 |
Tier 1 |
$8.00 | $12.00 | None | $124.01 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-085 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NMS (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Preferred NMS (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$8.50 | $25.50 | None | $128.21 |
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 |
HealthSpring HealthyLiving Preferred NMS (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Preferred NMS (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.00 |
$0 |
to be determined |
2 |
Tier 2 |
$8.50 | $25.50 | None | $128.21 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
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 H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
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 H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-086 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.10 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $164.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-088 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $174.43 |
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 H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
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 H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-089 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.50 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | Q:30 /30Days | $174.43 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
![Email Prescription and/or Health Benefit details for Windsor Medicare Extra Fusion Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $115.60 |
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 H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
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 H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
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 H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-128 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.20 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | Q:30 /30Days | $167.78 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
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 |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
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 |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring HealthyLiving Premier (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $118.33 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NMS (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyAdvantage Select NMS (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.70 |
$0 |
to be determined |
2 |
Tier 2 |
$8.50 | $25.50 | None | $128.21 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NMS (
![Email Prescription and/or Health Benefit details for HealthSpring HealthyAdvantage Select NMS (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$42.70 |
$0 |
to be determined |
2 |
Tier 2 |
$8.50 | $25.50 | None | $128.21 |
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 |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
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 |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
![Email Prescription and/or Health Benefit details for HealthSpring OptimaCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$62.00 |
$0 |
to be determined |
2 |
Tier 2 |
$10.00 | $30.00 | None | $119.85 |
Browse Plan Formulary |