2011 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips | |||||||||||
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Plan Name | County | Monthly Prem. (Parts C & D) |
Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance 30-Day Supply |
MOOP for Part A & B Benefits | |||||
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
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HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Aitkin | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Anoka | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Becker | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Beltrami | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Benton | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Big Stone | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Blue Earth | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Brown | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Carlton | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Carver | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Cass | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Chippewa | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Chisago | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Clay | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Clearwater | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Cook | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Cottonwood | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Crow Wing | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Dakota | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Dodge | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Douglas | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Faribault | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Fillmore | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Freeborn | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Goodhue | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Grant | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Hennepin | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Houston | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Hubbard | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Isanti | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Itasca | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Jackson | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Kanabec | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Kandiyohi | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Kittson | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Koochiching | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
|||||
Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Lac qui Parle | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Lake | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Lake of the Woods | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Le Sueur | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Lincoln | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Lyon | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Mahnomen | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Marshall | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Martin | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
McLeod | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Meeker | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Mille Lacs | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Morrison | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Mower | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Murray | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Nicollet | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Nobles | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Norman | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Olmsted | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Otter Tail | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Pennington | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Pine | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Pipestone | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Polk | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Pope | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Ramsey | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Red Lake | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Redwood | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Renville | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Rice | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Rock | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Roseau | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Scott | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Sherburne | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Sibley | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
St. Louis | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Stearns | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Steele | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Stevens | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Swift | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Todd | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Traverse | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Wabasha | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Wadena | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Waseca | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Washington | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Watonwan | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Wilkin | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
Plan Name | County | Monthly Prem. |
Deduct- ible |
Additional Gap Coverage |
Preferred Pharmacy Copay/ Coinsurance |
MOOP for A & B |
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Service | Exper. | Cost Info | |||||||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Winona | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Wright | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
HealthPartners Freedom Plan II Standard Rx (Cost) in MN - H2462-008-0 Benefit Details |
Yellow Medicine | $104.60 | $230 | No additional gap coverage, only the Donut Hole Discount | Generic Drugs: $10.00 Preferred Brand Drugs: $45.00 Non-Preferred Brand Drugs: $95.00 Specialty Tier Drugs: 33% | $3,000 Browse Formulary | |||||
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