ORTHOCLONE OKT-3 5MG/5ML (5 X 5ML AMP) (NDC: 59676010101)
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 |
Windsor Medicare Extra Emerald Plan (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Gold Plan (HMO)
|
$15.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
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)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $985.62 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$27.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Windsor Medicare Extra Diabetes Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Diamond Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $1,197.09 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
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)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | None | $1,126.22 |
Browse Plan Formulary |