ROCEPHIN/DEX INJ 1GM (NDC: 00004200278)
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 |
FreedomBlue PPO HD Rx (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO HD Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $230.00 | None | $833.82 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-099 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-099 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-101 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-101 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-101 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-101 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-077 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-077 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-077 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-077 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
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 |
4 |
Tier 4 |
33% | 33% | None | $726.64 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-074 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-074 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
FreedomBlue PPO Select (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.70 |
$0 |
to be determined |
3 |
Tier 3 |
$90.00 | $225.00 | None | $826.74 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-100 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-100 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | None | $833.82 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | None | $833.82 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | None | $833.82 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $245.00 | None | $833.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-076 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-076 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.50 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
HumanaChoice R5826-081 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-081 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.00 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $1,065.78 |
Browse Plan Formulary |
FreedomBlue PPO Classic (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $826.74 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-075 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-075 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $1,065.78 |
Browse Plan Formulary |
HumanaChoice R5826-002 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-002 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$35.70 |
$0 |
to be determined |
3 |
Tier 3 |
$85.00 | $212.50 | None | $1,065.78 |
Browse Plan Formulary |
FreedomBlue PPO Platinum (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Platinum (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$66.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $826.74 |
Browse Plan Formulary |