TOBRAMYCIN INHALATION SOLUTION (NDC: 00078049471)
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 |
AARP MedicareComplete Plus Plan 1 (HMO-POS
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plus Plan 1 (HMO-POS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,258.76 |
Browse Plan Formulary |
AARP MedicareComplete Plus Plan 1 (HMO-POS
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plus Plan 1 (HMO-POS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,258.76 |
Browse Plan Formulary |
Advantra Option 4 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 4 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 4 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
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 |
Advantra Option 4 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 4 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,258.76 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,258.76 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,258.76 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 55 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,276.01 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $4,517.60 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,440.65 |
Browse Plan Formulary |
Evercare Plan MH-POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Evercare Plan MH-POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,302.89 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH-POS (HMO-POS)
![Email Prescription and/or Health Benefit details for Evercare Plan MH-POS (HMO-POS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$13.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,302.89 |
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) |
$16.70 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,466.46 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.20 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,466.46 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.10 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,427.18 |
Browse Plan Formulary |
HumanaChoice H1418-011 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-011 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-011 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-011 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-012 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-012 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H1418-014 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-014 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,473.54 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,410.04 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,353.56 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $4,448.45 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,435.66 |
Browse Plan Formulary |
Aetna Medicare Open Value Plan w/Rx (PFFS)
![Email Prescription and/or Health Benefit details for Aetna Medicare Open Value Plan w/Rx (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.70 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | P Q:8400 /28Days | $4,435.66 |
Browse Plan Formulary |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,255.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,255.40 |
Browse Plan Formulary |
HumanaChoice H1418-010 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-010 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-043 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-043 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Advantra Option 3 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 3 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 3 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
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 |
Advantra Option 3 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Advantra Option 3 (HMO)
![Email Prescription and/or Health Benefit details for Advantra Option 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,252.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
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 H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
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 H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
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 H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,258.79 |
Browse Plan Formulary |
HumanaChoice R5826-009 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-009 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P Q:280 /28Days | $4,233.42 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,242.13 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
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 H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
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 H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:280 /28Days | $4,232.94 |
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 |
Health Alliance Medicare PPO10 Rx (PPO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO10 Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx (PPO)
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO10 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO10 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
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 |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
2 |
Tier 2 |
$39.00 | $117.00 | None | $4,489.38 |
Browse Plan Formulary |