VALCYTE 450MG TABLET (60 TABLETS BOT) (NDC: 00004003822)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible | Does Plan Offer Gap Coverage | Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,876.50 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $4,841.52 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $4,841.52 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $4,841.52 |
Browse Plan Formulary |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $4,841.52 |
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 |
Arcadian Health Plan - Plus (HMO)
|
$0.00 |
$0 | to be determined | 5 |
Tier 5 |
33% | 33% | None | $4,841.52 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,876.50 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,876.50 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,876.50 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,876.50 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,866.15 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,866.15 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,866.15 |
Browse Plan Formulary |
Generations Healthcare Classic powered by
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,967.35 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,872.60 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,872.60 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 55 (
|
$0.00 |
$0 | to be determined | 4 |
Tier 4 |
33% | 33% | None | $4,872.60 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Value powered by CCRx (PFF
|
$6.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,948.15 |
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:120 /30Days | $4,970.82 |
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:120 /30Days | $4,970.82 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Value powered by CCRx (PFF
|
$8.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
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:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 2 powered by CCR
|
$8.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
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:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Today's Options Advantage 1 powered by CCR
|
$8.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Generations Healthcare Premier powered by
|
$9.30 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,967.35 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,952.11 |
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:120 /30Days | $4,952.11 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,944.49 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Advantage 3 powered by CCR
|
$19.70 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,971.67 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Plan Name |
Monthly 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
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$19.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,966.42 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
|
$22.10 |
$0 | to be determined | 5 |
Tier 5 |
33% | n/a | None | $5,226.98 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Today's Options Premier powered by CCRx (P
|
$22.40 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,970.82 |
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:120 /30Days | $4,970.82 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-023 (PFFS)
|
$24.20 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,841.54 |
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:120 /30Days | $4,954.72 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Humana Gold Choice H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-022 (PFFS)
|
$30.30 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,844.90 |
Browse Plan Formulary |
HumanaChoice H8644-003 (PPO)
|
$31.70 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.63 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Plan Name |
Monthly 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 H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Humana Gold Choice H2944-021 (PFFS)
|
$36.00 |
$0 | to be determined | 2 |
Tier 2 |
$40.00 | $100.00 | Q:120 /30Days | $4,831.91 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$38.80 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,948.15 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option II (PFFS)
|
$39.90 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
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:120 /30Days | $4,955.63 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
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
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
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
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Today's Options Premier powered by CCRx (P
|
$44.60 |
$0 | to be determined | 4 |
Tier 4 |
33% | n/a | P Q:120 /30Days | $4,975.30 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible | Gap Coverage | Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,149.23 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,151.04 |
Browse Plan Formulary |
Sterling Option IV (PFFS)
|
$44.70 |
$225 | to be determined | 3 |
Tier 3 |
25% | 25% | None | $5,135.85 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
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 |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
Browse Plan Formulary |
Medicare Blue PPO (PPO)
|
$45.50 |
$0 | to be determined | 2 |
Tier 2 |
$34.00 | $102.00 | None | $5,158.44 |
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:120 /30Days | $4,952.11 |
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:120 /30Days | $4,952.11 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.65 |
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:120 /30Days | $4,958.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
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:120 /30Days | $4,958.77 |
Browse Plan Formulary |
Plan Name |
Monthly 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:120 /30Days | $4,958.77 |
Browse Plan Formulary |