VIVITROL INJECTABLE SUSPENSION 380MG/VIAL (NDC: 65757030001)
2010 Medicare Prescription Drug Plan (MAPD) Information
Click here for the Chart Legend |
Plan Name |
Monthly Prem. |
De- duct- ible |
Does Plan Offer Gap Coverage |
Drug Tier Information |
Cost-Sharing |
Drug Usage Mgmt |
Plan’s Avg. Retail Drug Price 30-Day |
Tier Nbr. |
Tier Desc. |
30-Day Prfrd. Pharm |
90-Day Mail Order |
AARP MedicareComplete Plan 3 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 3 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Essence Advantage (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | 20% | P | $928.11 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | 20% | P | $928.11 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | 20% | P | $928.11 |
Browse Plan Formulary |
Essence Advantage Special Needs Plan (HMO)
![Email Prescription and/or Health Benefit details for Essence Advantage Special Needs Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
20% | 20% | P | $928.11 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Humana Gold Choice H1804-290 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H1804-290 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $950.24 |
Browse Plan Formulary |
Clear Care Vital (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Vital (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.00 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $945.36 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
|
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
SecureHorizons MedicareDirect Rx Plan 59 (
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareDirect Rx Plan 59 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AARP MedicareComplete Plan 2 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 2 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
AARP MedicareComplete Plan 1 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 1 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $994.23 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $1,017.06 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $957.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Four (P
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Four (P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $957.92 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $992.83 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.50 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $978.73 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Humana Gold Choice H2944-072 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-072 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $949.69 |
Browse Plan Formulary |
Clear Care Essential (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Essential (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.40 |
$310 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $945.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-063 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-063 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-064 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-064 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-061 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-061 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Regence MedAdvantage + Rx Classic (PPO)
![Email Prescription and/or Health Benefit details for Regence MedAdvantage + Rx Classic (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$38.80 |
$255 |
to be determined |
4 |
Tier 4 |
26% | n/a | None | $977.58 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-062 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-062 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Clear Care Optimal (HMO)
![Email Prescription and/or Health Benefit details for Clear Care Optimal (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.10 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | None | $945.36 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-060 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-060 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-059 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-059 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $950.24 |
Browse Plan Formulary |
Regence MedAdvantage + Rx Enhanced (PPO)
![Email Prescription and/or Health Benefit details for Regence MedAdvantage + Rx Enhanced (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$66.60 |
$0 |
to be determined |
4 |
Tier 4 |
30% | n/a | None | $977.58 |
Browse Plan Formulary |