PYLERA 125-125MG CAPSULE (120 BOT) (NDC: 58914060021)
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 |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-134 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-134 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
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 H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
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 H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-136 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-136 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.70 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
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 H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
Humana Gold Choice H2944-133 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-133 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.66 |
Browse Plan Formulary |
HumanaChoice R5826-079 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-079 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.60 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | Q:120 /30Days | $1,079.95 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
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 H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
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 H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
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 H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-135 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-135 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.20 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
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 |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
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 |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
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 |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
Humana Gold Choice H2944-137 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-137 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | Q:120 /30Days | $1,079.59 |
Browse Plan Formulary |
HumanaChoice R5826-003 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-003 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | Q:120 /30Days | $1,079.95 |
Browse Plan Formulary |