REBETOL 200MG CAPSULE 84 EA (NDC: 00085119403)
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
5 |
Tier 5 |
33% | n/a | None | $954.68 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,118.67 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,118.67 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,118.67 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,118.67 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,095.39 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | None | $1,108.10 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | 33% | None | $1,196.13 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
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 |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
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 |
4 |
Tier 4 |
25% | 25% | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
HumanaChoice H3619-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H3619-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:168 /28Days | $1,094.23 |
Browse Plan Formulary |
UPMC for Life HMO Rx Enhanced Ohio (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life HMO Rx Enhanced Ohio (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:186 /31Days | $940.56 |
Browse Plan Formulary |
UPMC for Life HMO Rx Enhanced Ohio (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life HMO Rx Enhanced Ohio (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:186 /31Days | $940.56 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced Ohio (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced Ohio (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:186 /31Days | $940.56 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced Ohio (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced Ohio (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | Q:186 /31Days | $940.56 |
Browse Plan Formulary |