VALTREX 1GM CAPLET (90 CT) (90 BOT) (NDC: 00173056510)
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 |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Bravo Achieve (HMO)
![Email Prescription and/or Health Benefit details for Bravo Achieve (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Classic (HMO)
![Email Prescription and/or Health Benefit details for Bravo Classic (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PPO HD Rx (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO HD Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $371.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$1.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$4.00 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 150
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 150](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.90 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 51 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 51 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$11.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $116.00 | None | n/a |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.10 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.30 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
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 |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
FreedomBlue PFFS Choice Plus (PFFS)
![Email Prescription and/or Health Benefit details for FreedomBlue PFFS Choice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.60 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $372.77 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Gold (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Gold (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.70 |
$0 |
to be determined |
3 |
Tier 3 |
$35.00 | $70.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.75 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.40 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.74 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
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 |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
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 |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.10 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.15 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Open 3 $0 Deductible Rx (PF
![Email Prescription and/or Health Benefit details for Geisinger Gold Open 3 $0 Deductible Rx (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$18.50 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.10 |
$0 |
to be determined |
2 |
Tier 2 |
$44.00 | $110.00 | Q:30 /1Days | $393.35 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $377.79 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $375.40 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | $187.50 | None | $373.22 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
FreedomBlue PPO Select (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Select (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.70 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $112.50 | None | $371.53 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Any, Any, Any Platinum (PFFS)
![Email Prescription and/or Health Benefit details for Any, Any, Any Platinum (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.30 |
$0 |
to be determined |
3 |
Tier 3 |
$30.00 | $60.00 | Q:90 /90Days | $370.55 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Bravo Freedom (PPO)
![Email Prescription and/or Health Benefit details for Bravo Freedom (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.70 |
$0 |
to be determined |
2 |
Tier 2 |
$35.00 | $70.00 | Q:90 /90Days | $370.64 |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | None | n/a |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | None | n/a |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | None | n/a |
Browse Plan Formulary |
Evercare Plan MP (PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan MP (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $125.00 | None | n/a |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Secure 2 (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Secure 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$28.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.53 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 1 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.47 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.53 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
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 |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Classic 3 Standard Rx (HMO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 3 Standard Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.21 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.43 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $361.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.32 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.32 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.32 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.32 |
Browse Plan Formulary |
Geisinger Gold Preferred Standard Rx (PPO)
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred Standard Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.00 |
$310 |
to be determined |
2 |
Tier 2 |
25% | 25% | None | $362.32 |
Browse Plan Formulary |
FreedomBlue PPO Classic (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.00 |
$0 |
to be determined |
2 |
Tier 2 |
$42.00 | $105.00 | None | $371.53 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Community Living (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Community Living (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life Specialty Plan (HMO)
![Email Prescription and/or Health Benefit details for UPMC for Life Specialty Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.10 |
$0 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | n/a |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.53 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
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 |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 1 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 1 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.53 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.63 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.40 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.93 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.42 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $362.94 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Geisinger Gold Classic 2 $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Classic 2 $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.36 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
Geisinger Gold Preferred $0 Deductible Rx
![Email Prescription and/or Health Benefit details for Geisinger Gold Preferred $0 Deductible Rx](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
$69.00 | $172.50 | None | $361.73 |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
UPMC for Life PPO Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for UPMC for Life PPO Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$55.10 |
$0 |
to be determined |
2 |
Tier 2 |
$30.00 | $75.00 | None | n/a |
Browse Plan Formulary |
FreedomBlue PPO Platinum (PPO)
![Email Prescription and/or Health Benefit details for FreedomBlue PPO Platinum (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$66.60 |
$0 |
to be determined |
2 |
Tier 2 |
$40.00 | $100.00 | None | $371.53 |
Browse Plan Formulary |