RIBASPHERE 400MG TABLET (56 BOT) (NDC: 66435010356)
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 |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
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 |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Choice + Rx (HMO-POS)
![Email Prescription and/or Health Benefit details for Amerivantage Choice + Rx (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
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 |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Amerivantage Classic + Rx (HMO)
![Email Prescription and/or Health Benefit details for Amerivantage Classic + Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $726.10 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Bravo Choice (HMO)
![Email Prescription and/or Health Benefit details for Bravo Choice (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$8.30 |
$0 |
to be determined |
1 |
Tier 1 |
$3.00 | $6.00 | P | $860.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $818.74 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $818.74 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
![Email Prescription and/or Health Benefit details for Today's Options Value powered by CCRx (PFF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $817.71 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $866.68 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $821.86 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $821.86 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $821.86 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $821.86 |
Browse Plan Formulary |
Bravo Liberty II Rx (PFFS)
![Email Prescription and/or Health Benefit details for Bravo Liberty II Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $821.86 |
Browse Plan Formulary |
Evercare Plan IP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan IP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.70 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | P | $848.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $818.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $818.74 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $808.51 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
![Email Prescription and/or Health Benefit details for Today's Options Premier powered by CCRx (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:60 /30Days | $761.72 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Plan Name |
Monthly 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 Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P | $769.98 |
Browse Plan Formulary |