QUALAQUIN 324MG CAPSULE (NDC: 13310015307)
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 Select (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,102.76 |
Browse Plan Formulary |
Anthem Senior Advantage Basic (HMO)
![Email Prescription and/or Health Benefit details for Anthem Senior Advantage Basic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,102.76 |
Browse Plan Formulary |
Anthem Senior Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Anthem Senior Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,102.76 |
Browse Plan Formulary |
Blue Medicare Access Standard (Regional PP
![Email Prescription and/or Health Benefit details for Blue Medicare Access Standard (Regional PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,103.26 |
Browse Plan Formulary |
Blue Medicare Access Value (Regional PPO)
![Email Prescription and/or Health Benefit details for Blue Medicare Access Value (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,103.26 |
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 |
SummaCare Secure Silver Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for SummaCare Secure Silver Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P | $1,051.31 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
4 |
Tier 4 |
$68.00 | $136.00 | None | $1,033.19 |
Browse Plan Formulary |
Anthem Medicare Preferred Standard (PPO)
![Email Prescription and/or Health Benefit details for Anthem Medicare Preferred Standard (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$2.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | P | $1,102.76 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.00 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,033.46 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$9.00 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,033.46 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.50 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | P | $1,028.62 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-121 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-121 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,057.52 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,057.52 |
Browse Plan Formulary |
Health Plan SecureCare (HMO)
![Email Prescription and/or Health Benefit details for Health Plan SecureCare (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | None | $1,044.66 |
Browse Plan Formulary |
SecureChoice (PPO)
![Email Prescription and/or Health Benefit details for SecureChoice (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | None | $1,051.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
4 |
Tier 4 |
$74.00 | $148.00 | None | $1,035.06 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.80 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,033.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$21.80 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,033.46 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,057.52 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,057.52 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
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 |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,046.06 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,051.02 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $87.50 | P | $1,061.93 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
Browse Plan Formulary |
Humana Gold Choice H2944-129 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-129 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.41 |
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 H2944-122 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-122 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-122 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-122 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-131 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-131 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-131 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-131 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.30 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,023.70 |
Browse Plan Formulary |
Humana Gold Choice H2944-132 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-132 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$24.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,024.37 |
Browse Plan Formulary |
Humana Gold Choice H2944-123 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-123 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,024.37 |
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 |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
4 |
Tier 4 |
$80.00 | $160.00 | None | $1,035.21 |
Browse Plan Formulary |
HumanaChoice R5826-007 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-007 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.20 |
$0 |
to be determined |
3 |
Tier 3 |
$82.00 | $205.00 | P Q:42 /30Days | $1,024.75 |
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 |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $1,029.11 |
Browse Plan Formulary |
Unison Advantage Plus (HMO)
![Email Prescription and/or Health Benefit details for Unison Advantage Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.50 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $1,029.11 |
Browse Plan Formulary |
HumanaChoice R5826-080 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-080 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | P Q:42 /30Days | $1,024.75 |
Browse Plan Formulary |
HumanaChoice H3619-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H3619-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | P Q:42 /30Days | $1,024.76 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
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 |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
Advantage Plan Securex (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Securex (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.70 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,051.06 |
Browse Plan Formulary |
SummaCare Secure Platinum (HMO-POS)
![Email Prescription and/or Health Benefit details for SummaCare Secure Platinum (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.60 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $210.00 | P | $1,051.31 |
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 |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option II (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option II (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.90 |
$225 |
to be determined |
2 |
Tier 2 |
$34.00 | $68.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.51 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.71 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
![Email Prescription and/or Health Benefit details for Sterling Option IV (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.70 |
$225 |
to be determined |
2 |
Tier 2 |
$36.00 | $72.00 | None | $1,088.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SummaCare Secure Gold Plus (HMO-POS)
![Email Prescription and/or Health Benefit details for SummaCare Secure Gold Plus (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.00 |
$0 |
to be determined |
3 |
Tier 3 |
$60.00 | $180.00 | P | $1,051.31 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
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 |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,050.87 |
Browse Plan Formulary |
Advantage Plan Optimumx (HMO-POS)
![Email Prescription and/or Health Benefit details for Advantage Plan Optimumx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$57.10 |
$0 |
to be determined |
3 |
Tier 3 |
$50.00 | $150.00 | None | $1,052.43 |
Browse Plan Formulary |