ABRAXANE 100MG VIAL (1 X 100 MG VIALSD) (NDC: 68817013450)
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 Balance (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $971.17 |
Browse Plan Formulary |
AARP MedicareComplete Balance (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $971.17 |
Browse Plan Formulary |
AARP MedicareComplete Balance (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $971.17 |
Browse Plan Formulary |
AARP MedicareComplete Balance (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Balance (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $971.17 |
Browse Plan Formulary |
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 | $971.17 |
Browse Plan Formulary |
Plan Name |
Monthly 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 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 | $971.17 |
Browse Plan Formulary |
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 | $971.17 |
Browse Plan Formulary |
AARP MedicareComplete Plan 4 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $969.00 |
Browse Plan Formulary |
AARP MedicareComplete Plan 4 (HMO)
![Email Prescription and/or Health Benefit details for AARP MedicareComplete Plan 4 (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $969.00 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
4 |
Tier 4 |
33% | 33% | P | $964.71 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $919.92 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Classic I: Medicare Extra Needs
![Email Prescription and/or Health Benefit details for Elderplan Classic I: Medicare Extra Needs](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Elderplan Medicare Part B Premium Reductio
![Email Prescription and/or Health Benefit details for Elderplan Medicare Part B Premium Reductio](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $981.18 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $968.51 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $968.51 |
Browse Plan Formulary |
Evercare Plan MH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan MH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $968.51 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $983.70 |
Browse Plan Formulary |
GHI Medicare PPO Value (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $983.70 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $992.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Medicaid Advantage (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Medicaid Advantage (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$310 |
to be determined |
3 |
Tier 3 |
40% | 40% | P | $980.63 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
MediBlue Value (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Value (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
MediBlue Value (PPO)
![Email Prescription and/or Health Benefit details for MediBlue Value (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,041.77 |
Browse Plan Formulary |
SecureHorizons MedicareComplete Choice (Re
![Email Prescription and/or Health Benefit details for SecureHorizons MedicareComplete Choice (Re](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $970.87 |
Browse Plan Formulary |
MediBlue Plus (HMO)
![Email Prescription and/or Health Benefit details for MediBlue Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$2.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$5.50 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$10.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
MediBlue Plus (PPO)
![Email Prescription and/or Health Benefit details for MediBlue Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$12.90 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $843.43 |
Browse Plan Formulary |
BlueShield Senior Blue HMO 651 PartD (HMO)
![Email Prescription and/or Health Benefit details for BlueShield Senior Blue HMO 651 PartD (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$14.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
GHI Medicare PPO II (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO II (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$15.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
AmeriChoice Personal Care Plus (HMO)
![Email Prescription and/or Health Benefit details for AmeriChoice Personal Care Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $968.33 |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
![Email Prescription and/or Health Benefit details for AmeriChoice Personal Care Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $968.33 |
Browse Plan Formulary |
AmeriChoice Personal Care Plus (HMO)
![Email Prescription and/or Health Benefit details for AmeriChoice Personal Care Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$16.30 |
$310 |
to be determined |
2 |
Tier 2 |
15% | 15% | P | $968.33 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-002 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-002 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$17.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.00 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO Plan ONE (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO Plan ONE (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$19.30 |
$150 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $980.63 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
Browse Plan Formulary |
Aetna Medicare Value Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Value Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.80 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
Browse Plan Formulary |
Humana Gold Choice H4774-004 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-004 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $992.65 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
HIP VIP Plus (HMO)
![Email Prescription and/or Health Benefit details for HIP VIP Plus (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
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 |
5 |
Tier 5 |
33% | n/a | P | $1,015.66 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
Browse Plan Formulary |
Plan Name |
Monthly 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 | $964.71 |
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 | $964.71 |
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 | $964.71 |
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 | $985.21 |
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 | $985.21 |
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 | $985.21 |
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 |
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 | $985.21 |
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 | $985.21 |
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 | $985.21 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 751 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 751 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.20 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
Evercare Plan RMP (Regional PPO)
![Email Prescription and/or Health Benefit details for Evercare Plan RMP (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$23.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $970.87 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere (PFFS
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere (PFFS](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.60 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
Browse Plan Formulary |
Aetna Medicare Standard Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Standard Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$27.60 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
Browse Plan Formulary |
Humana Gold Choice H4774-003 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-003 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.60 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-005 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-005 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$29.90 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
Humana Gold Choice H4774-001 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H4774-001 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$30.80 |
$0 |
to be determined |
4 |
Tier 4 |
33% | n/a | P | $963.65 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.40 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
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 |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Senior Blue HMO 652 P
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Senior Blue HMO 652 P](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.00 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
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 |
Evercare Plan IH (HMO)
![Email Prescription and/or Health Benefit details for Evercare Plan IH (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$310 |
to be determined |
4 |
Tier 4 |
25% | 25% | None | $1,008.26 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Independent Health Medicare Anywhere Basic
![Email Prescription and/or Health Benefit details for Independent Health Medicare Anywhere Basic](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $1,006.05 |
Browse Plan Formulary |
Senior Whole Health PLUS of New York (HMO)
![Email Prescription and/or Health Benefit details for Senior Whole Health PLUS of New York (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$33.30 |
$310 |
to be determined |
2 |
Tier 2 |
$45.00 | $135.00 | None | $828.67 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
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 |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $944.58 |
Browse Plan Formulary |
Aetna Medicare Select Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Select Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $944.58 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Medicare Blue PPO - TWO (PPO)
![Email Prescription and/or Health Benefit details for Medicare Blue PPO - TWO (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$37.10 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $980.63 |
Browse Plan Formulary |
BlueShield Senior Blue HMO 652 PartD (HMO)
![Email Prescription and/or Health Benefit details for BlueShield Senior Blue HMO 652 PartD (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$39.40 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
GoldAnywhere Rx (PPO)
![Email Prescription and/or Health Benefit details for GoldAnywhere Rx (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$40.90 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $932.43 |
Browse Plan Formulary |
Advantage Platinum NY - Suffolk (HMO)
![Email Prescription and/or Health Benefit details for Advantage Platinum NY - Suffolk (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$41.20 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $969.49 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $944.58 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $944.58 |
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 |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$43.20 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $973.73 |
Browse Plan Formulary |
Advantage Health Suffolk - SNP (HMO)
![Email Prescription and/or Health Benefit details for Advantage Health Suffolk - SNP (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.30 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $969.49 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $972.72 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$44.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $972.72 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
GHI Medicare PPO III (PPO)
![Email Prescription and/or Health Benefit details for GHI Medicare PPO III (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$45.80 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 50% | P | $980.63 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
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 |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Independent Health Medicare Passport (PPO)
![Email Prescription and/or Health Benefit details for Independent Health Medicare Passport (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.20 |
$0 |
to be determined |
3 |
Tier 3 |
$75.00 | n/a | None | $972.47 |
Browse Plan Formulary |
Preferred Gold Rx (HMO)
![Email Prescription and/or Health Benefit details for Preferred Gold Rx (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$47.40 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | None | $932.43 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.60 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $979.25 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.60 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $979.25 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$50.60 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $979.25 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
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 |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Independent Health Encompass 65 Extra (HMO
![Email Prescription and/or Health Benefit details for Independent Health Encompass 65 Extra (HMO](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$52.10 |
$0 |
to be determined |
3 |
Tier 3 |
$65.00 | n/a | None | $972.21 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (PPO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.30 |
$0 |
to be determined |
5 |
Tier 5 |
25% | 25% | None | $944.58 |
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 |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $979.25 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $979.25 |
Browse Plan Formulary |
Aetna Medicare Premier Plan (HMO)
![Email Prescription and/or Health Benefit details for Aetna Medicare Premier Plan (HMO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$54.60 |
$0 |
to be determined |
5 |
Tier 5 |
33% | 33% | None | $979.25 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
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 |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$69.50 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
MediBlue Plus (PPO)
![Email Prescription and/or Health Benefit details for MediBlue Plus (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$70.20 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | P | $1,042.18 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
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 |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 752 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 752 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$73.60 |
$0 |
to be determined |
3 |
Tier 3 |
50% | 42% | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
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 |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
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 |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueShield Forever Blue Medicare PPO 755 (
![Email Prescription and/or Health Benefit details for BlueShield Forever Blue Medicare PPO 755 (](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$123.70 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
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 |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |
BlueCross BlueShield Forever Blue Medicare
![Email Prescription and/or Health Benefit details for BlueCross BlueShield Forever Blue Medicare](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$157.10 |
$0 |
to be determined |
3 |
Tier 3 |
$40.00 | $100.00 | None | $911.42 |
Browse Plan Formulary |