PEG-INTRON REDIPEN 150MCG (NDC: 00085137001)
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 |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $2,322.03 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $2,322.03 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $2,322.03 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $2,322.03 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | P | $2,322.03 |
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 |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
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 |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,338.79 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,351.96 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,351.96 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,351.96 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.53 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.94 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.94 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
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 |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
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 |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
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 |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,385.70 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,385.70 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$11.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,373.87 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,389.23 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
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 |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
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 |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
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 |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,371.22 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
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 | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,413.54 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.94 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.94 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
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 H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,337.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,335.76 |
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 |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,342.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,327.34 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.53 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,384.22 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,382.73 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 5 |
Tier 5 |
30% | 30% | P | $2,474.60 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,385.70 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,385.70 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,378.83 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
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 |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,383.72 |
Browse Plan Formulary |