TYKERB 250MG TABLET (150 BOT) (NDC: 00173075200)
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 |
HumanaChoice H4956-003 (PPO)
|
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,801.41 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
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 |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$6.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,761.84 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,780.83 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,761.84 |
Browse Plan Formulary |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,780.83 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$9.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$10.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$12.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
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 |
Today's Options Value powered by CCRx (PFF
|
$13.60 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$13.70 |
$310 |
to be determined |
4 |
Tier 4 |
25% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
|
$14.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$14.80 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
|
$16.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | Q:450 /90Days | $3,622.26 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,730.73 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$16.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,801.41 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$18.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.92 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-084 (PFFS)
|
$18.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-087 (PFFS)
|
$21.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Plan Name |
Monthly 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)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $3,837.61 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
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 |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
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 |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,759.05 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-085 (PFFS)
|
$23.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NMS (
|
$26.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Preferred NMS (
|
$26.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$26.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,762.44 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H2944-086 (PFFS)
|
$27.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-088 (PFFS)
|
$28.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Humana Gold Choice H2944-089 (PFFS)
|
$29.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,684.31 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Windsor Medicare Extra Fusion Plan (HMO)
|
$32.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | P | $3,706.52 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Humana Gold Choice H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H1804-128 (PFFS)
|
$32.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,662.11 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
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 |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring HealthyLiving Premier (HMO)
|
$38.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
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 |
HealthSpring HealthyAdvantage Select NMS (
|
$42.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,747.06 |
Browse Plan Formulary |
HealthSpring HealthyAdvantage Select NMS (
|
$42.70 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,747.06 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,757.40 |
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 |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$47.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,768.84 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
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 |
Today's Options Premier powered by CCRx (P
|
$50.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,765.18 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$53.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P Q:150 /30Days | $3,749.30 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
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 |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |
HealthSpring OptimaCare (HMO)
|
$62.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $3,753.40 |
Browse Plan Formulary |