PEG-INTRON REDIPEN 80MCG (NDC: 00085131601)
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 |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UnitedHealthcare Personal Care Plus (HMO)
|
$0.00 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | P | n/a |
Browse Plan Formulary |
UCare for Seniors Value Plus (HMO-POS)
|
$2.80 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | Q:4 /28Days | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$4.50 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,280.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.30 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $1,839.16 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
Browse Plan Formulary |
SmartValue Plus (PFFS)
|
$5.70 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | P | $2,214.58 |
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 | $2,176.04 |
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 | $2,176.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
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 | $2,176.04 |
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 | $2,176.04 |
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 | $2,176.04 |
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 | $2,176.04 |
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 | $2,176.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
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 | $2,176.04 |
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 | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.07 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
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 | $2,159.07 |
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 | $2,159.07 |
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 | $2,159.07 |
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 | $2,159.07 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $2,159.07 |
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 | $2,159.07 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,171.97 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
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 | $2,228.12 |
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 | $2,228.12 |
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 | $2,228.12 |
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 | $2,170.38 |
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 | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
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 | $2,170.38 |
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 | $2,170.38 |
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 | $2,171.97 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$9.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.60 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,158.60 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 150
|
$10.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,110.92 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
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 |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
|
$11.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,118.30 |
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 | $2,154.01 |
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 | $2,154.01 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 | to be determined | 4 |
Tier 4 |
25% | n/a | P Q:4 /28Days | $2,154.01 |
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 | $2,166.08 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-067 (PFFS)
|
$16.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,121.41 |
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 | $2,158.07 |
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 | $2,158.07 |
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 | $2,158.07 |
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 | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
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 | $2,170.38 |
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 | $2,170.38 |
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 | $2,170.38 |
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 | $2,170.38 |
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 | $2,170.38 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$16.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,170.38 |
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 | $2,170.38 |
Browse Plan Formulary |
Advocare Essence Rx (HMO-POS)
|
$17.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,146.95 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Plan Name |
Monthly 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 3 powered by CCR
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$18.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,176.04 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-065 (PFFS)
|
$19.90 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-069 (PFFS)
|
$20.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5216-008 (PPO)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,127.54 |
Browse Plan Formulary |
HumanaChoice H5216-008 (PPO)
|
$21.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,127.54 |
Browse Plan Formulary |
UCare for Seniors Classic (HMO-POS)
|
$21.50 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | Q:4 /28Days | $2,280.13 |
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 | $2,159.07 |
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 | $2,159.07 |
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 | $2,159.07 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.07 |
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 | $2,159.07 |
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 | $2,159.07 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,206.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,206.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,206.26 |
Browse Plan Formulary |
Plan Name |
Monthly 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-POS (HMO-POS)
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,206.26 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,206.26 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,228.12 |
Browse Plan Formulary |
Plan Name |
Monthly 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-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Plan Name |
Monthly 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-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Plan Name |
Monthly 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-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
|
$22.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | P | $2,108.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Humana Gold Choice H2944-070 (PFFS)
|
$23.20 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,108.61 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Advocare Vitality Rx (HMO-POS)
|
$25.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,146.95 |
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 | $2,158.60 |
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 | $2,158.60 |
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 | $2,158.60 |
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 | $2,158.60 |
Browse Plan Formulary |
Advocare Spirit Rx (HMO-POS)
|
$27.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P | $2,146.95 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Community Health Partnership (HMO)
|
$32.20 |
$310 | to be determined | 2 |
Tier 2 |
n/a | n/a | Q:4 /28Days | $2,171.06 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
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 H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Humana Gold Choice H2944-066 (PFFS)
|
$33.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,123.22 |
Browse Plan Formulary |
Medica Prime Solution Value (Cost)
|
$38.00 |
$55 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,129.20 |
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 | $2,154.18 |
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 | $2,154.18 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
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 | $2,154.18 |
Browse Plan Formulary |
Medica Prime Solution Basic w/Standard Rx
|
$38.90 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,128.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medica Prime Solution Enhanced w/Standard
|
$38.90 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,128.04 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 | $2,155.79 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,155.79 |
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 | $2,155.79 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,159.44 |
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 | $2,154.01 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:4 /28Days | $2,154.01 |
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 | $2,154.01 |
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 | $2,166.08 |
Browse Plan Formulary |
Medica Prime Solution Basic w/Enhanced Rx
|
$67.90 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,128.04 |
Browse Plan Formulary |
Medica Prime Solution Enhanced w/Enhanced
|
$67.90 |
$0 | to be determined | 4 |
Tier 4 |
25% | 25% | None | $2,128.04 |
Browse Plan Formulary |