ANTIZOL INJECTION 1GM 4 X 1.5ML VIAL CRTN (4 X 1.5 ML VIAL CRTN) (NDC: 68727020002)
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 |
SecurityChoice Plus (PFFS)
![Email Prescription and/or Health Benefit details for SecurityChoice Plus (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
|
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
Plan Name |
Monthly 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) |
$0.00 |
$0 |
to be determined |
5 |
Tier 5 |
33% | n/a | None | $5,563.70 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
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 |
CIGNA Medicare Access Plus RX Plan Two (PF
![Email Prescription and/or Health Benefit details for CIGNA Medicare Access Plus RX Plan Two (PF](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$20.00 |
$0 |
to be determined |
4 |
Tier 4 |
33% | 33% | P | $6,500.65 |
Browse Plan Formulary |
HumanaChoice H1418-011 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-011 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-011 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-011 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-012 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-012 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-014 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-014 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$22.00 |
$0 |
to be determined |
3 |
Tier 3 |
$70.00 | $175.00 | None | $6,360.16 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 | $6,500.65 |
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 |
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 | $6,500.65 |
Browse Plan Formulary |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H5525-004 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H5525-004 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$25.80 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-010 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-010 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$26.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-043 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-043 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$31.90 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-041 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-041 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$32.60 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice R5826-009 (Regional PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice R5826-009 (Regional PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.30 |
$310 |
to be determined |
3 |
Tier 3 |
25% | 25% | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-040 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-040 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$34.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Humana Gold Choice H2944-042 (PFFS)
![Email Prescription and/or Health Benefit details for Humana Gold Choice H2944-042 (PFFS)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.10 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
HumanaChoice H1418-013 (PPO)
![Email Prescription and/or Health Benefit details for HumanaChoice H1418-013 (PPO)](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$36.40 |
$0 |
to be determined |
3 |
Tier 3 |
$80.00 | $200.00 | None | $6,360.16 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |
Plan Name |
Monthly Prem. |
De- duct- ible |
Gap Coverage |
Tier Nbr. |
Tier Desc. |
30-Day Prfd. Pharm |
90-Day Mail Order |
Drug Usage Mgmt |
Retail Drug Price |
Health Alliance Medicare PPO30 Rx Plus (PP
![Email Prescription and/or Health Benefit details for Health Alliance Medicare PPO30 Rx Plus (PP](https://q1medicare.com/pics/ContentPics/email_medicare_plan_details.png) |
$80.00 |
$0 |
to be determined |
3 |
Tier 3 |
$88.00 | $264.00 | None | $6,522.45 |
Browse Plan Formulary |